Abstract
Background: Systematic review and meta-analysis were performed to evaluate efficacy and safety of anticoagulant therapy in patients with chronic cirrhosis complicated with portal vein thrombosis (PVT). Methods: The PubMed, The Cochrane Library and Web of Science databases were searched. The odds ratio (OR) and risks ratio(RR) with 95% CI was pooled to calculate the difference in the rate of portal vein recanalization and occurrence of bleeding events between patients who received anticoagulation and those who did not. All meta-analysis were conducted by using a random-effects model. Results: 8 studies with a total of 559 patients published between 2005 and 2019 were finally enrolled in our meta-analysis . The rate of portal vein recanalization was significantly higher with PVT who received anticoagulation and those who did not (OR = 4.689, 95% (95% CI = 3.274–6.716, P=0.000). And the pooled risk ratio of bleeding between the two groups was 0.828 (95% CI = 0.511–1.343, P=0.444). The heterogeneity was not statistically significant among studies, Begg’s funnel plot and Egger’s linear regression test were performed to evaluate publicantion bias. Conclusion: Anticoagulation therapy can significantly improve the recanalization rate of PVT patients with cirrhosis, and the bleeding related events caused by anticoagulation are relatively low, which is worthy of clinical promotion. However, more prospective trials are needed to know how to use anticoagulants.
Efficacy and safety of anticoagulant therapy in patients with chronic cirrhosis complicated with portal vein thrombosis: what should we expert from a meta-analysis?