Clinical Outcome of 127 Cases of Splanchnic Venous Thrombosis: Benefit of Anticoagulant Therapy

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2610-2610
Author(s):  
Lucia Canafoglia ◽  
Serena Rupoli ◽  
Gianluca Svegliati Baroni ◽  
Michele Gironella ◽  
Giorgia Micucci ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Clinical Outcome ◽  
Incidence Rate ◽  
Anticoagulant Therapy ◽  
Esophageal Varices ◽  
Univariate Analysis ◽  
Bleeding Events ◽  
Risk Of Bleeding ◽  
Prophylactic Dose

Abstract Background: Splanchnic venous thrombosis (SVT) encompasses thrombosis in the mesenteric, splenic or portal veins (with or without hepatic veins involvement). Little is known about appropriate therapeutic interventions and long-term clinical outcome of SVT patients. Aim of this study was to identify the correct management of SVT and encourage a multidisciplinary approach by a team composed of hematologists, hepatologists, and infectivologists. Methods:We analyzed clinical, laboratory, therapeutic and outcome data of 127 patients with SVT that were recruited from 2000 to 2016. In patients with no active bleeding, anticoagulation treatment was started as soon as possible, according to platelet count. We administered intermediate or full therapeutic dose low-molecular-weight heparin (LMWH) and early initiation of vitamin-K antagonist (VKA; INR range 2-3 or 1.8-2.5 in patients with high bleeding risk) for a platelet count >50.000/μl, only half or prophylactic dose of LMWH for a platelet count >30.000 and < 50.000/μl and no treatment for a platelet count <30.000/μl. Indefinite duration treatment was used for patients with persistent or permanent risk (i.e. cirrhosis, active solid cancer and hematological cancer). Moreover, an appropriate prophylaxis with beta-blockers and endoscopic therapies were applied in cirrhotic SVT. The quality of VKA treatment was assessed by the time in therapeutic range (TTR). The number of vascular complications was expressed as incidence rate, calculated by the number of events per 100 patients-year of observation. The Kaplan-Meier method was performed to estimate the time to reach vessel recanalization. Cox regression analysis was used to identify independent predictors of vascular events or recanalization. Results: Overall, 127 patients were included (median age 58 years; 74% males). The median follow-up of all patients was 11 months (1-212). Portal vein thrombosis was the most common site of thrombosis (50%), followed by multiple venous involvement (37%). Liver cirrhosis and solid neoplasms were the common underlying disease (72% and 36% respectively) while myeloproliferative neoplasms were identified in 8 patients (6.2%). Eighty-nine patients (70%) had esophageal varices (grade >2 in 55 patients) and 81 (64%) had thrombocytopenia (mean 72.000/μl range 28.000/μl-148.000/μl). Ninety-nine patients (78%) were treated with anticoagulant therapy: 36% with intermediate or full dose of LMWH, 40% with half or prophylactic dose of LMWH and 24% with VKA (TTR 76%). During a median duration therapy of 7 months, the incidence rate of thrombotic events was 1.1 per 100 pt-y while the incidence rate of major bleeding was 1.6 per 100 pt-y. At univariate analysis, esophageal varices (p=0.030), renal failure (p=0.001) and liver cirrhosis (p=0.05) significantly increased the risk of bleeding events. Moreover VKA exposure was associated with a significantly lower risk of bleeding events compared to LMWH (p=0.042). Fifty-six patients (44%) obtained vessel recanalization and the probability of recanalization of the occluded vessels was 50% at 18 months. At univariate analysis, factors associated with a lack of recanalization included liver cirrhosis (p=0.004) and solid tumor (p=0.010). Only one death was attributed to fatal bleeding whereas 31 patients died for causes not related to anticoagulation (cirrhosis, cancer). Conclusions: Our study suggests the effectiveness of anticoagulant therapy (especially VKA), leading to thrombus recanalization in 44% of patients with SVT. Notably, the anticoagulant treatment was associated with a very low bleeding incidence also in patients with major risk factors for bleeding (i.e. liver cirrhosis, cancer or esophageal varices). Treatment algorithm and therapeutic decisions were taken as a multidisciplinary team, able to adapt the individual approach and avoid fatal complications. Disclosures Offidani: Janssen: Honoraria; Celgene: Honoraria, Research Funding.

scholarly journals Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis

2017 ◽  
Vol 15 (2) ◽  
pp. 37-40
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Sandip Khadka ◽  
Kiran Regmi ◽  
Pooja KC
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Diameter Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not. Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively. Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.

scholarly journals Platelet Count/Splenic Diameter Ratio to Predict Oesophageal Varices in Portal Hypertension

2019 ◽  
Vol 2 (2) ◽  
pp. 192-196
Author(s):  
Buddhi Sagar Lamichhane ◽  
Manoj Koirala ◽  
Bishwo Raj Baral
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Rural Areas ◽  
Predictive Value ◽  
Tertiary Hospital ◽  
Diameter Ratio ◽  
Oesophageal Varices ◽  
Cirrhosis Of Liver

Background: One of the major causes of morbidity and mortality in Nepal is portal hypertension due to liver cirrhosis. In rural areas where a lot of cases of cirrhosis of liver are prevalent and endoscopic expertise and facilities are not available, predicting the presence of esophageal varices through non-invasive means may reduce a large number of unnecessary endoscopies. This study is to identify the relationship of platelet count /splenic bipolar diameter ratio with the presence of esophageal varices in portal hypertension. Materials and methods: Eighty patients were included in this study between Jestha 2072 to Baisakh 2073 with the diagnosis of portal hypertension admitted in Bir hospital, Kathmandu which is a tertiary hospital of government of Nepal, which were mostly due to liver cirrhosis. The patients fulfilling the inclusion criteria underwent lab investigations, ultra sonogram and UGI endoscopy. The data were assessed for descriptive studies and means were compared using t-test. The cut off value of platelet count to spleen diameter ratio of 1150 was used to predict the presence or absence of oesophageal varices. Statistical analysis was done using SPSS 20 software Results: Platelet count to splenic diameter ratio with a cut off value of 1150 has sensitivity of 89.7%, specificity of 83.3%, positive predictive value of 96.8% and negative predictive value of 58.8% (p= 0.002, CI=95%) with 89.5 % accuracy. Conclusion: Platelet count to splenic bipolar diameter ratio can be a good predictor of presence of esophageal varices in patients with portal hypertension in the resource poor settings.

Surveillance Study of Temporary IVC Filters placed in Patients with VTE and Contraindications for Full Dose Anticoagulant Therapy

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3034-3034
Author(s):  
Angel G. Galvez ◽  
Benjamin Parsons ◽  
Daniel Resnick ◽  
Morawa Ewelina ◽  
Abhilasha Radharkrishnan ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Anticoagulant Therapy ◽  
Low Dose ◽  
Medical Information ◽  
Trauma Patients ◽  
Ivc Filter ◽  
Full Dose ◽  
Risk Of Bleeding ◽  
Prophylactic Dose ◽  
Ivc Filters

Abstract To study the circumstances surrounding the use of IVC filters in our institution we collected medical information from all patients with IVC filters placed between January 1, 2006 and December 31, 2007 in our institution. During this time, 247 IVC filters were placed and we are reporting preliminary data of 50 of those patients. Of these patients, 8 (16%) had permanent filters placed (Vena tech™) and 42 (84%) had retrievable filters (Gunther Tulip filters). In most of the cases, the indication for the IVC filter was the inability to use full dose of anticoagulants in patients with acute DVT secondary to active bleeding, requiring immediate surgery or very high risk of bleeding due to different circumstances (such a recent intracranial bleed or traumatic intra-abdominal hemorrhage). Most of the patients were trauma patients. Thus, 30 of the patients had neurosurgical injuries, 13 had orthopedic injuries requiring urgent surgery, 5 had intra-abdominal injuries and 2 were medical patients with DVT and contraindications for anticoagulant therapy. Of the filters deployed, 12 (24%) were inserted after developing thrombosis despite the use of prophylactic dose of anticoagulants. Once the filter was inserted, surveillance Doppler studies revealed propagation of the clots in 7 (14%) patients. Of these 7 patients 2(29%) of them were receiving low dose enoxaparin and 5 (71%) were receiving no anticoagulants at all. In addition, there were 12 patients with DVT and contraindication to full dose anticoagulation who were treated with prophylactic dose of enoxaparin. Of these 12 patients, 10(83%) had stability or resolution of the thrombus and 2(17%) showed propagation. Twenty patients were given no anticoagulation after diagnosis of DVT, of them, 15(75%) had resolution or stabilization of the clots and 5(25%) experienced propagation. Most of the patients were eventually treated with full dose enoxaparin followed by warfarin for a minimum of 3 months. All IVC filters were inserted by intervention radiologists at our institution. Deployment was done uneventfully in all cases. The retrieval of all filters was done between 4 and 8 weeks of the time of insertion. By then, most of the patients were taking warfarin. This drug was held 3 evenings before the procedure and restarted 8–12 hours after the procedure. Enoxaparin at a dose of 40 mg SQ daily was use for bridging before and after the retrieval of the IVC filters. Of all temporary filters, only 11 (26%) were retrieved. IVC filter could not be retrieved despite attempting it in 1 (2%) of patients. The reason for this was that the filter had embedded in the intima of the IVC. Additionally, 1(2%) patient required two attempts to successfully remove the filter IVC filters as there was residual thrombus at the filter site the first time. IVC retrievable filters were effective in preventing pulmonary embolism in 49 (98%) of patients. The only patient with a pulmonary embolism was a neurosurgical patient that was not treated with anticoagulants and the clot extended to the filter. Excessive bleeding occurred in 2(4%) of all patients resulting in discontinuation of anticoagulants. IVC filters are safe and constitute a reasonable intervention to prevent pulmonary embolism in patients with contraindications for anticoagulation. Although, many temporary filters are placed they are often not retrieved. Low dose enoxaparin in patients with IVC filter and contraindication for full dose anticoagulants is associated to low risk of bleeding and seems to prevent proximal propagation of the clots. We expect to have all data from the 247 patients collected by the time of the Meeting.

scholarly journals Risk of Major Bleeding with Ibrutinib in Patients with Thrombocytopenia - a Retrospective Single-Center Canadian Study

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4682-4682
Author(s):  
Mina Dehghani ◽  
Taylor Dear ◽  
Anthony Quint ◽  
Martha L Louzada ◽  
Selay Lam ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Major Bleeding ◽  
Univariate Analysis ◽  
Primary Objective ◽  
Canadian Study ◽  
Bleeding Events ◽  
Advisory Committees ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Grade 3

Abstract Introduction: Ibrutinib, an oral Bruton Kinase inhibitor, is a highly effective treatment for patients with chronic lymphocytic leukemia (CLL). Previous studies reported an increased risk of bleeding due to impaired platelet function. Patients with CLL experience significant thrombocytopenia, which increases their risk for bleeding. This population was excluded from major trials and data is lacking to inform management in this setting. Methods: This is a single center retrospective study of all adult patients with CLL who received single agent ibrutinib in London, Ontario, Canada between January 2014 to December 2020. The primary objective was to investigate the risk of major bleeding associated with thrombocytopenia. Secondary objective was to investigate potential predictors of bleeding. Bleeding events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) grading system. A major bleed was defined as CTCAE grade 3 or higher as well as bleeding in the central nervous system. To assess the effect of independent variables on the outcome of bleeding, univariate analysis using chi square and t-tests was performed. Multivariate analysis was then preformed with the variables that were significant (p&lt;0.05) on univariate analysis, using logistic and cox regression models. Results: A total of 170 patients were included in this study. There were 54 bleeding events documented in 42 patients (24.7 %) of which 19(35 %) were major bleeding occurring in 17 patients. Median time to major bleeding was 2.4 months. Of the patients with major bleeding, 4(21%) were on anticoagulation, 2(10%) were on antiplatelet and 2(10%) were on combined anticoagulation and antiplatelet. There were 8 central nervous system (CNS) bleeding and 2 of them died. The mean platelet (PLT) nadir, defined as lowest PLT count at any point during ibrutinib treatment, was 73 x 10 9/Lin patients with major bleeding compared to 116 x 10 9/L in patients with minor and 91 x 10 9/L in patients with no bleeding events. On the univariate analysis, when compared patients with major bleeding to patients with no bleeding, potential predictors of major bleeding included PLT nadir (p=0.09), haemoglobin (Hb) &lt; 100 g/L at ibrutinib initiation (p=0.027) and anticoagulation (p=0.009). When compared patients with major bleeding to patients with minor or no bleeding, potential predictors of major bleeding included PLT nadir (p=0.045), Hb &lt;100 (p=0.036) and anticoagulation (p=0.06). Grade 3 thrombocytopenia, defined as PLT nadir &lt; 50 at any point during treatment with ibrutinib was not associated with increased risk of major bleeding (p=0.2). To confirm the significance of these variables, multivariate analysis was performed. When compared patients with major bleeding to patients with no bleeding, PLT nadir (OR= 0.9, p=0.008) and anticoagulation (OR=4.02, p=0.001) were confirmed to be the potential predictors of major bleeding. When compared patients with major bleeding to patients with minor or no bleeding, PLT nadir (OR=0.9 p=0.005) and Hb &lt;100 (OR=2.34, p=0.005) were the potential predictors of major bleeding. Conclusions: Although not common, Ibrutinib is associated with increased risk of bleeding and identifying high risk patients is essential to prevent major bleeding events. This retrospective Canadian study was done with the primary objective to assess the association between PLT count and major bleeding in patients on ibrutinib for treatment of CLL. In this analysis patients with major bleeding tend to have lower PLT counts compared to patients with minor or no bleeding, with mean PLT nadir of 73x 10 9/L. However, grade 3 thrombocytopenia (PLT nadir&lt;50) was not associated with increased risk of major bleeding. Other important predictors of increased risk of major bleeding while on ibrutinib include anticoagulation and anemia (Hb &lt;100). Figure 1 Figure 1. Disclosures Louzada: Amgen: Honoraria; Pfizer: Honoraria; Celgene: Honoraria; Janssen: Honoraria. Lam: AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees; Millennium: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Hoffmann-La Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; SeaGen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol-Meyers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Servier: Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees; Johnson & Johnson: Honoraria, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees; Beigene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees. Phua: Amgen: Honoraria; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria; NovoNordisk: Honoraria, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Honoraria.

scholarly journals Noninvasive prediction of large esophageal varices in liver cirrhosis patients

2014 ◽  
Vol 37 (1) ◽  
pp. 38 ◽  
Author(s):  
Lijing Wang ◽  
JunWei Hu ◽  
Shuang Dong ◽  
Yi Cheng Jian ◽  
Lijuan Hu ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Regression Model ◽  
Predictive Models ◽  
Esophageal Varices ◽  
Predictive Accuracy ◽  
Univariate Analysis ◽  
Upper Gastrointestinal Endoscopy ◽  
Stepwise Logistic Regression ◽  
Variceal Hemorrhage ◽  
Multiple Variables

Purpose: Esophageal varices are a dangerous complication of liver cirrhosis. The development of cost effective, noninvasive means for prediction of large esophageal varices could reduce the use of upper gastrointestinal endoscopy in variceal screening and also provide an alternative way to confirm the results of conventional endoscopic diagnosis. Previously proposed predictive models are neither sensitive nor specific. Methods: A retrospective study based on a group of 104 liver cirrhosis patients was performed. Multiple statistical approaches were used to evaluate the association of large esophageal varices with 20 individual and six compound clinical laboratory variables. A new predictive model was developed. Results: Univariate analysis suggested that eight out of 26 variables were significantly associated with large esophageal varices. Further stepwise logistic regression eventually identified three variables (hemoglobin level, portal vein diameter and the ratio of platelet count/spleen diameter) that contributed significantly to the final regression model. Receiver operating characteristic (ROC) curve analysis showed that this new regression model achieved 77.8% and 72% of diagnostic sensitivity and specificity, respectively, for the prediction of large esophageal varices. In our study group, its diagnostic accuracy (AUROC=0.814) was found to be significantly higher than six predictive models previously published. Conclusions: No single variable offers self-sufficient predictive function for large esophageal varices. A comprehensive model using multiple variables significantly improves the predictive accuracy in screening the most at risk patients with potential variceal hemorrhage.

Bleeding Complications and Transfusion Threshold in Thrombopenic Patients Receiving Antithrombotic Therapy.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 962-962
Author(s):  
Jean-Louis H. Kerkhoffs ◽  
Rinie J. van Wordragen-Vlaswinkel ◽  
Jeroen C.J. Eikenboom ◽  
Anneke Brand
Keyword(s):  
At Risk ◽  
Platelet Count ◽  
Anticoagulant Therapy ◽  
Platelet Transfusion ◽  
Diagnosis And Treatment ◽  
Bleeding Complications ◽  
Red Cell ◽  
Transfusion Threshold ◽  
Risk Of Bleeding ◽  
The Mean

Abstract Introduction: Central venous catheters are frequently used in hematooncological patients for the administration of chemotherapy, antibiotics and parenteral feeding. Despite low platelet counts, observed in this category of patients, catheter related thrombosis (VTE), with the need for anticoagulant therapy, still occurs in 9.7% of the patients. Treatment of this complication in our institute consists of the removal of the catheter and anti-coagulant therapy, consisting of conventional heparin or low molecular weight heparin. Although solely based on expert opinion, the generally accepted platelet transfusion threshold of 10 x 109/l is raised to 20 – 40 x 109/l. In our institute a trigger of 30 x 109/l is used. We investigated whether this trigger policy is effective in the prevention of bleeding complications. Methods: We performed a case-control study to study bleeding complications and threshold policy. From 1 February 2000 to 1 May 2005 we reviewed medical records of patients, admitted at the hematology department of the Leiden University Medical Center. A total of 22 patients were identified having thrombosis confirmed by ultrasound or phlebography. The database of a recently performed clinical trial in our institution was used to select a control group. Thirty-one controls were selected, matched for age, gender, diagnosis and treatment. For each patient, we calculated the days at risk of bleeding, i.e. days of thrombocytopenia with or without anti-coagulant therapy and recorded bleeding complications, platelet and red cell transfusions from the medical charts. Statistical analysis was performed using SPSS. Results: There were no significant differences between patients with or without VTE in regard to age, gender, diagnosis and treatment. The number of days at risk of bleeding for patients without VTE was 511 days and for VTE group 239 days. The table shows the number of bleeding complications, the mean platelet count, the mean platelet transfusion threshold and the number of platelet and red cell transfusions. Both univariate as multivariate analysis (including age, gender, diagnosis, treatment and VTE-status) showed a significant effect of the existence of VTE on the occurrence of bleeding complications. The Odds’ ratio of bleeding in the VTE group compared to the non-VTE group was 2.9 (CI 95: 1.7 – 5.0; p = 0.0002). More then 95% of the bleeding complications consisted of WHO grades I and II. No lethal bleeding was observed. Discussion: Patients experiencing (catheter-related) venous thrombosis treated with anticoagulant therapy during a period of thrombocytopenia showed an increased risk of bleeding complications, despite a higher platelet transfusion threshold. Whether steering between Scylla and Charibdis can be facilitated by raising the platelet transfusion threshold remains to established. Study outcome No VTE VTE p value n = number Days at risk 511 239 n bleeding complications per day at risk 0.05 0.13 0.0002 mean platelet count (10E9/l) +/− SD 28 +/− 16 38 +/− 17 &lt; 0.0001 mean platelet transfusion threshold (10E9/l) +/− SD 12 +/− 9 28 +/− 12 &lt; 0.0001 n platelet transfusions per day at risk 0.35 0.49 0.0003 n red cell transfusions per day at risk 0.34 0.41 0.073

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.

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