Synonymous variants of ADAMTS13 affect codon usage. (A) Synonymous ADAMTS13 variants with significantly different RSCU (ΔRSCU) or relative synonymous bicodon usage for 2 codon pairs (ΔRSBCU-5′ and ΔRSBCU-3′) compared with WT ADAMT S13. Green stars indicate significant values. (B) sSNVs with significantly different codon adaptation index (ΔW). (C) Variants with significant changes in CPS for 5′ or for 3′ codon pair. Green stars indicate whether change in CPS is significant for each variant and each codon pair. (D) Variants that result in significantly different %MinMax values. All δ values presented here are significant. (E) Overlap between variants that significantly affect ΔRSCU, relative synonymous bicodon usage ΔRS BCU, Δ%MinMax, and ΔW. Ten sSNVs that significantly affect all 4 parameters appear in red along with their exon and encoded protein domain. Differences considered significant where P < .05 (see the supplemental Methods for a description of P value computation and supplemental Excel File 1 for P values).