Antithrombotic treatment with direct-acting oral anticoagulants in patients with splanchnic vein thrombosis and cirrhosis
Autor: | De Gottardi, Andrea, Trebicka, Jonel, Klinger, Christoph, Plessier, Aurélie, Seijo, Susana, Terziroli, Benedetta, Magenta, Lorenzo, Semela, David, Buscarini, Elisabetta, Langlet, Philippe, Görtzen, Jan, Puente, Angela, Müllhaupt, Beat, Navascuès, Carmen, Nery, Filipe, Deltenre, Pierre, Turon, Fanny, Engelmann, Cornelius, Arya, Rupen, Caca, Karel, Peck‐Radosavljevic, Markus, Leebeek, Frank W. G., Valla, Dominique, Garcia‐Pagan, Juan Carlos, Grønbæk, Henning, Beer, Jürg‐Hans, Genescà, Joan, Hidalgo, Canete, Vila, Carmen, Mihailovic, Jelena, Piscaglia, Fabio, Lasser, Luc, Fernandez‐Bermejo, Miguel, Procopet, Bogdan, Schouten, Jeoffrey, Spahr, Laurent, Sanchez, José Louis, Zipprich, Alexander, Sekhar, Mallika, Hernandez‐Guerra, Manuel, Laguna, La, Nevens, Frederik, Ferreira, Carlos Noronha, Heneghan, Michael, Albillos, Agustin, Llop, Elba, Dell'Era, Alessandra, La Mura, Vincenzo, Primignani, Massimo, Senzolo, Marco, Escarda, Ana, Mallorca, Palma, Riggio, Oliviero, Murad, Sarwa Darwish, Haas, Stephan, Bureau, Christophe, Berenguer, Marina |
---|---|
Přispěvatelé: | De Gottardi, Andrea, Trebicka, Jonel, Klinger, Christoph, Plessier, Aurélie, Seijo, Susana, Terziroli, Benedetta, Magenta, Lorenzo, Semela, David, Buscarini, Elisabetta, Langlet, Philippe, Görtzen, Jan, Puente, Angela, Müllhaupt, Beat, Navascuès, Carmen, Nery, Filipe, Deltenre, Pierre, Turon, Fanny, Engelmann, Corneliu, Arya, Rupen, Caca, Karel, Peck-Radosavljevic, Marku, Leebeek, Frank W. G., Valla, Dominique, Garcia-Pagan, Juan Carlo, on behalf of the VALDIG Investigators: [.., Fabio Piscaglia, ], University of Zurich, Hematology |
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Budd-Chiari syndrome
medicine.medical_specialty Deep vein 610 Medicine & health 03 medical and health sciences Anticoagulation 0302 clinical medicine Journal Article medicine Portal vein thrombosi Cirrhosis Portal vein thrombosis Hepatology Rivaroxaban Cirrhosi business.industry medicine.disease Thrombosis 3. Good health Surgery Venous thrombosis medicine.anatomical_structure 10219 Clinic for Gastroenterology and Hepatology Splanchnic vein thrombosis 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Apixaban 2721 Hepatology Liver function business medicine.drug |
Zdroj: | de Gottardi, A, Trebicka, J, Klinger, C, Plessier, A, Seijo, S, Terziroli, B, Magenta, L, Semela, D, Buscarini, E, Langlet, P, Görtzen, J, Puente, A, Müllhaupt, B, Navascuès, C, Nery, F, Deltenre, P, Turon, F, Engelmann, C, Arya, R, Caca, K, Peck-Radosavljevic, M, Leebeek, F W G, Valla, D, Garcia-Pagan, J C, VALDIG Investigators (Henning Grønbæk, member) & Grønbæk, H 2017, ' Antithrombotic treatment with direct-acting oral anticoagulants in patients with splanchnic vein thrombosis and cirrhosis ', Liver International, vol. 37, no. 5, pp. 694-699 . https://doi.org/10.1111/liv.13285 Liver International, 37(5), 694-699. Wiley-Blackwell Publishing Ltd Liver International |
ISSN: | 1478-3223 |
DOI: | 10.7892/boris.93571 |
Popis: | BACKGROUND: Direct-acting oral anticoagulants (DOACs) are used in patients with splanchnic vein thrombosis (SVT) and cirrhosis, but evidence for safety and efficacy in this setting is limited. Our aim was to identify indications and reasons for starting or switching to DOACs and to report adverse effects, complications and short-term outcome.METHODS: Data collection including demographic information, laboratory values, treatment and complications through the Vascular Liver Disease Interest Group Consortium.RESULTS: Forty-five centres (90%) of the consortium completed the initial eCRF. We report here a series of 94 patients from 17 centres. Thirty-six patients (38%) had cirrhosis. Child-Pugh score was 6 (range 5-8), and MELD score 10.2 (range 6-19). Indications for anticoagulation were splanchnic vein thrombosis (75%), deep vein thrombosis (5%), atrial fibrillation (14%) and others (6%). DOACs used were rivaroxaban (83%), dabigatran (11%) and apixaban (6%). Patients were followed up for a median duration of 15 months (cirrhotic) and 26.5 months (non-cirrhotic). Adverse events occurred in 17% of patients and included one case of recurrent portal vein thrombosis and five cases of bleeding. Treatment with DOACs was stopped in three cases. The major reasons for choosing DOACs were no need for monitoring or inadequacy of INR to guide anticoagulation in cirrhotic patients. Renal and liver function did not change during treatment.CONCLUSIONS: A consistent number of patients with SVT and/or cirrhosis are currently treated with DOACs, which seem to be effective and safe. These data provide a basis for performing randomized clinical trials of DOACs vs. low molecular weight heparin or vitamin K antagonists. |
Databáze: | OpenAIRE |
Externí odkaz: |