scholarly journals Nontumorous Portal Vein Thrombosis in Liver Cirrhosis: Possible Role of β-Blockers

2018 ◽  
Vol 27 (5) ◽  
pp. 466-471 ◽  
Author(s):  
Lydia Giannitrapani ◽  
Walter Granà ◽  
Anna Licata ◽  
Cosima Schiavone ◽  
Giuseppe Montalto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Logistic Regression Analysis ◽  
Esophageal Varices ◽  
Univariate Analysis ◽  
Vein Thrombosis ◽  
Β Blockers

Objective: Nonselective β-blockers (NSBB) are used in liver cirrhosis (LC) to prevent variceal bleeding because they decrease portal pressure. A main risk factor for the development of portal vein thrombosis (PVT) in LC is decreased portal vein inflow velocity. The aim of our study was to examine retrospectively the incidence of PVT and its correlation with the use of β-blockers in a cohort of LC patients. Subjects and Methods: Data from 230 LC patients (90% Child-Pugh class A), who had been followed up for at least 5 years, were reviewed. The diagnosis of PVT was made by ultrasound. The presence of PVT was evaluated with multiple logistic regression analysis where the independent variables were those significant in the univariate analysis. Results: The prevalence of PVT at baseline was 4.5%, and the incidence was 4.3% at 5 years; among the subjects taking β blockers, 46.4% were taking NSBB. A total of 19 PVT cases were found. Grade of esophageal varices (p < 0.01), PLT (p < 0.003), INR (p < 0.03), spleen diameter (p < 0.001) and PLT/spleen ratio (p < 0.0005) were significantly associated with PVT. The use of NSBB indicated a higher risk of PVT compared to selective β-blockers (SBB) (p < 0.05). In logistic regression analysis only the grade of esophageal varices was significant (p < 0.02). Univariate analysis of patients taking β-blockers showed an association of PVT with grade of esophageal varices (p < 0.01), CP class (p < 0.02), AST (p < 0.03), ALT and albumin (p < 0.02), PLT count and PLT/LD (p < 0.03), longitudinal diameter of the spleen (p < 0.005), ascites (p < 0.05), portal vein (p < 0.0001) and NSBB (OR 8.1; 95% CI 1.7–38.8). Conclusion: NSBB seem to play a role in PV thrombogenesis. Further studies are needed, especially in decompensated LC patients.

scholarly journals Early Initiation of Anticoagulation Improves the Long-Term Prognosis in Patients With Antiphospholipid Syndrome Associated Portal Vein Thrombosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Hanxiao You ◽  
Jiuliang Zhao ◽  
Can Huang ◽  
Xinping Tian ◽  
Mengtao Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Survival Analysis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Antiphospholipid Syndrome ◽  
Associated Factors ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Vein Thrombosis

Objectives: Portal vein thrombosis (PVT) is a rare and severe clinical phenotype of antiphospholipid syndrome (APS) with a poor prognosis. Anticoagulation therapy is efficient but is associated with potentially severe bleeding episodes, especially for those patients with thrombocytopenia. We conducted this case-control study to explore the clinical features and associated factors of PVT in APS patients, the re-canalization rate of the PVT after anticoagulation and investigate the beneficial effects of early initiation of anticoagulation in patients with APS associated PVT.Methods: We enrolled patients with APS associated PVT as the case group, and age-, and entry-time-matched APS patients without PVT (1:2) as the control group. We explored the associated factors of PVT in APS patients using multivariate logistic regression analysis. The re-canalization rate of the PVT after anticoagulation was analyzed using the survival analysis.Results: A total of 34 patients (8 males and 26 females) with APS-PVT were enrolled, with a median follow-up time of 3 years (1.5, 7 years). Multivariate logistic regression analysis showed that thrombocytopenia (OR 6.4, 95%CI 1.561–26.218, P = 0.01), hypersensitive c-reactive protein &gt;3 mg/L (OR 4.57, 95%CI 1.426–14.666, P = 0.011), anti β2GPI positive (OR 5, 95%CI 1.816–13.772, P = 0.002) and aPL double-positive (OR 4.08, 95%CI 1.312–12.429, P = 0.013) were independent associated factors for PVT in APS. Survival analysis revealed that effective anticoagulation could increase re-canalization rate significantly (log-rank p = 0.001), with better prognosis (lower mortality rate, log-rank p = 0.045).Conclusions: PVT could be the first presentation of APS with insidious onset and atypical clinical symptoms and easily be misdiagnosed. For patients with APS, double aPLs positive, thrombocytopenia, and inflammation could be the associated factors of PVT. Early diagnosis and anticoagulation treatment can bring thrombus re-canalization thereby significantly improving the prognosis.

scholarly journals A case of liver cirrhosis with exaggerated portal vein thrombosis after endoscopic injection sclerotherapy(EIS) for esophageal varices.

Kanzo ◽  
1996 ◽  
Vol 37 (7) ◽  
pp. 393-399
Author(s):  
Yukio OHTSUKA ◽  
Nobyuoshi YANAGISAWA ◽  
Takeshi OINUMA ◽  
Keiko FUJIWARA ◽  
Atsushi MATSUTANI ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Esophageal Varices ◽  
Injection Sclerotherapy ◽  
Endoscopic Injection Sclerotherapy ◽  
Endoscopic Injection ◽  
Vein Thrombosis

Plasma YAP1 predicts esophageal varices and the risk of variceal bleeding in liver cirrhosis

2021 ◽  
Author(s):  
Wen Zhao ◽  
Ningning Xue ◽  
Po Cui ◽  
Lingdi Liu ◽  
Yiqi Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Liver Cirrhosis ◽  
Receiver Operating Characteristic ◽  
Logistic Regression Analysis ◽  
Esophageal Varices ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Receiver Operating

Aim: To explore the predictive value of plasma YAP1 for esophageal varices (EV) and high-risk EV (HRV) in patients with liver cirrhosis. Materials & methods: A total of 208 patients with liver cirrhosis were enrolled and categorized into four groups. Correlation analysis, logistic regression analysis and receiver operating characteristic curve analysis were performed to evaluate the diagnostic performance of plasma YAP1 for EV and HRV. Results: Plasma YAP1 levels were significantly elevated with the occurrence and progression of EV in cirrhotic patients. The multivariate logistic regression analysis revealed that plasma YAP1 is an independent predictor for EV and HRV. For predicting EV and HRV, the YAP1 cut-off values of 5.43 and 6.98 ng/ml yielded the area under the receiver operating characteristic curves of 0.944 and 0.955, respectively. Conclusion: Plasma YAP1 is a potential novel noninvasive biomarker for predicting EV and HRV in patients with liver cirrhosis.

scholarly journals Serum ADAMTS-13 Levels as an Indicator of Portal Vein Thrombosis

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Tomasz Mikuła ◽  
Joanna Kozłowska ◽  
Wojciech Stańczak ◽  
Mariusz Sapuła ◽  
Aleksandra Różyk ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Clinical Problem ◽  
Coagulation System ◽  
Decompensated Liver Cirrhosis ◽  
Vein Thrombosis ◽  
Bonferroni Test ◽  
The Mean

Background. Coagulation disorders in patients with liver cirrhosis are a common clinical problem. Cirrhosis should be considered a state of impaired blood clotting or an imbalance of the whole coagulation system. Cirrhosis-induced coagulopathy encompasses disturbances in both the procoagulant and anticoagulant systems. This mechanism may promote the development of thrombosis with portal vein thrombosis (PVT), which is considered an obstacle to orthotopic liver transplantation (OLT). We assessed serum ADAMTS-13 levels in patients with decompensated liver cirrhosis, with and without PVT. Material and Methods. Serum ADAMTS-13 levels, age, platelet count (PLT), and INR (international normalized ratio) were evaluated in (n=64) patients with liver cirrhosis either with PVT (group 1, n=31) or without PVT (group 2, n=33). The results were compared with those from healthy volunteers (group 3, n=37). Liver cirrhosis was based on Desmet’s classification of chronic hepatitis in liver biopsy stage ≥ 3 or liver elastography F-score ≥ 3. Serum ADAMTS-13 levels were measured with Quantikine® ELISA Human ADAMTS13 Immunoassay, R&D Systems Inc. We used Welch’s F-test, Games-Howell, one-way ANOVA, Bonferroni test, and logistic regression to determine whether ADAMTS-13 levels were a predictor that was independent of MELD and Child-Pugh scores. All results (P<0.05) were considered statistically significant. Results. The mean serum ADAMTS-13 level in patients with PVT was significantly lower than that in patients without PVT (P=0.001) and controls (P=0.001). The mean serum ADAMTS-13 level in patients without PVT was significantly lower than that in controls (P=0.001). ADAMTS-13 levels were significantly associated with PVT accounting for the Child-Pugh or MELD score in the logistic regression model. Conclusions. Low serum ADAMTS-13 levels can be a useful indicator of portal thrombosis in patients with decompensated liver cirrhosis irrespective of Child-Pugh or MELD scores. Further research is needed to determine whether ADAMTS-13 levels will find use in everyday clinical practice.

Antiphospholipid Antibodies and Antiphospholipid Syndrome: Role in Portal Vein Thrombosis in Patients With and Without Liver Cirrhosis

2010 ◽  
Vol 17 (4) ◽  
pp. 367-370 ◽  
Author(s):  
Lucio Amitrano ◽  
Paul R. J. Ames ◽  
Maria Anna Guardascione ◽  
Luis R. Lopez ◽  
Antonella Menchise ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Vein Thrombosis
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