Prevalence of CALR mutations in splanchnic vein thrombosis: A systematic review and meta-analysis

Abstract Background Splanchnic vein thrombosis (SVT) is a common complication in patients with liver cirrhosis. The aim of this study was to evaluate the efficacy and safety of anticoagulant therapy for SVT in cirrhotic patients. Methods In this systematic review and meta-analysis, studies reporting on SVT recanalization and progression, recurrent venous thromboembolism (VTE), major bleeding, and overall mortality were searched in MEDLINE, EMBASE, and ClinicalTrial.gov up to December 2019. Pooled proportions and risk ratios (RRs) with corresponding 95% confidence intervals (CIs) were calculated. Results A total of 1,475 patients were included in 26 studies (23 observational and 3 randomized controlled trials). In patients receiving anticoagulant therapy, SVT recanalization occurred in 68% (95% CI, 62–74; 571/842 patients; 22 studies), SVT progression in 6% (95% CI, 4–9; 25/748 patients; 22 studies), recurrent VTE in 10% (95% CI, 4–22; 48/399 patients; 7 studies), major bleeding in 6% (95% CI, 4–10; 58/785 patients; 18 studies), and overall mortality in 9% (95% CI, 6–14; 68/787 patients; 17 studies). Anticoagulant treatment was associated with higher SVT recanalization (RR 3.19; 95% CI, 1.42–7.17), lower thrombosis progression (RR 0.28; 95% CI, 0.15–0.52), major bleeding (RR 0.52; 95% CI, 0.28–0.97), and overall mortality (RR 0.42; 95% CI, 0.24–0.73) compared with no treatment. Conclusion Anticoagulant therapy seems to improve vein recanalization and to reduce SVT progression, major bleeding, and overall mortality in cirrhotic patients with SVT. The incidence of recurrent VTE during anticoagulation remains substantial.

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Prevalence of Splanchnic Vein Thrombosis in Pancreatitis: A Systematic Review and Meta-Analysis of Observational Studies

Gastroenterology Research and Practice ◽

10.1155/2015/245460 ◽

2015 ◽

Vol 2015 ◽

pp. 1-23 ◽

Cited By ~ 20

Author(s):

Wenda Xu ◽

Xingshun Qi ◽

Jiang Chen ◽

Chunping Su ◽

Xiaozhong Guo

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Meta Analysis ◽

Splenic Vein ◽

Inclusion Criteria ◽

Splanchnic Vein Thrombosis ◽

Vein Thrombosis ◽

Pooled Prevalence ◽

Meta Analyses ◽

Acute And Chronic Pancreatitis

Splanchnic vein thrombosis (SVT) may be negatively associated with the prognosis of pancreatitis. We performed a systematic review and meta-analysis of literatures to explore the prevalence of SVT in pancreatitis. All observational studies regarding the prevalence of SVT in pancreatitis were identified via PubMed and EMBASE databases. The prevalence of SVT was pooled in the total of patients with pancreatitis. And it was also pooled in the subgroup analyses according to the stage and causes of pancreatitis, location of SVT, and regions where the studies were performed. After the review of 714 studies, 44 studies fulfilled the inclusion criteria. Meta-analyses showed a pooled prevalence of SVT of 13.6% in pancreatitis. According to the stage of pancreatitis, the pooled prevalence of SVT was 16.6% and 11.6% in patients with acute and chronic pancreatitis, respectively. According to the causes of pancreatitis, the pooled prevalence of SVT was 12.2% and 14.6% in patients with hereditary and autoimmune pancreatitis. According to the location of SVT, the pooled prevalence of portal vein, splenic vein, and mesenteric vein thrombosis was 6.2%, 11.2%, and 2.7% in pancreatitis. The prevalence of SVT in pancreatitis was 16.9%, 11.5%, and 8.5% in Europe, America, and Asia, respectively.

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Anticoagulant therapy for splanchnic vein thrombosis: A systematic review and meta-analysis

Blood ◽

10.1182/blood.2020006827 ◽

2020 ◽

Author(s):

Emanuele Valeriani ◽

Marcello Di Nisio ◽

Nicoletta Riva ◽

Omri Cohen ◽

Juan-Carlos Garcia-Pagan ◽

...

Keyword(s):

Systematic Review ◽

Anticoagulant Therapy ◽

Major Bleeding ◽

Meta Analysis ◽

Splanchnic Vein Thrombosis ◽

Vein Thrombosis ◽

Therapeutic Decisions ◽

Recurrent Vte ◽

Anticoagulated Patients ◽

Overall Mortality

Treatment of splanchnic vein thrombosis (SVT) is challenging and evidence to guide therapeutic decisions remains scarce. The objective of this systematic review and meta-analysis was to determine the efficacy and safety of anticoagulant therapy for SVT. MEDLINE, EMBASE, and Clinicaltrial.gov were searched from inception up to December 2019 without language restrictions to include observational studies and randomized controlled trials reporting radiological or clinical outcomes in patients with SVT. Pooled proportions and risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model. Of 4312 records identified by the search, 97 studies including 7969 patients were analyzed. In patients receiving anticoagulation, the rates of SVT recanalization, SVT progression, recurrent VTE, major bleeding, and overall mortality were 58% (95% CI, 51-64), 5% (95% CI, 3-7), 11% (95% CI, 8-15), 9% (95% CI, 7-12), and 11% (95% CI, 9-14), respectively. The corresponding values in patients without anticoagulation were 22% (95% CI, 15-31), 15% (95% CI, 8-27), 14% (95% CI, 9-21), 16% (95% CI, 13-20), and 25% (95% CI, 20-31). Compared with no treatment, anticoagulant therapy obtained higher recanalization (RR 2.39; 95% CI, 1.66-3.44) and lower thrombosis progression (RR 0.24; 95% CI, 0.13-0.42), major bleeding (RR 0.73; 95% CI, 0.58-0.92), and overall mortality (RR 0.45; 95% CI, 0.33-0.60). These results demonstrate that anticoagulant therapy improves SVT recanalization and reduces the risk of thrombosis progression without increasing major bleeding. The incidence of recurrent VTE remains substantial also in anticoagulated patients. Effects were consistent across different subgroups of patients.

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