Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the “Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry” (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68 % men; 64 ± 12 years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44 %) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child–Pugh score; hepatocellular carcinoma was present in 20 %. The prevalence of ultrasound-detected portal vein thrombosis was 17 % (n = 126); it was asymptomatic in 43 % of the cases. Notably, more than half of the portal vein thrombosis patients (n = 81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p < 0.001), Child–Pugh Class B + C (p < 0.001), hepatocellular carcinoma (p = 0.01), previous upper gastrointestinal bleeding (p = 0.030) and older age (p = 0.012) were independently associated with portal vein thrombosis. Portal vein thrombosis is a frequent complication of cirrhosis, particularly in patients with moderate–severe liver failure. The apparent undertreatment of patients with portal vein thrombosis is a matter of concern and debate, which should be addressed by planning interventional trials especially with newer oral anticoagulants. Clinicaltrials.gov identifier NCT01470547.

Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry

Farcomeni A.;Di Michele D.;De Giorgi A.;Granito A.
Resources
;
Pettinari I.;Marinelli S.;Bolondi L.
Investigation
;
Falsetti L.;Salvi A.;Raimondo G.;Gallo P.;Cristina S.;Riccardi L.;Pietrangelo A.;Marcacci M.;Gargano R.;Vidili G.;Masala M.;Invernizzi P.;Senzolo M.;Del Ben M.;Proietti M.;Ruscio E.;
2016

Abstract

Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the “Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry” (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68 % men; 64 ± 12 years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44 %) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child–Pugh score; hepatocellular carcinoma was present in 20 %. The prevalence of ultrasound-detected portal vein thrombosis was 17 % (n = 126); it was asymptomatic in 43 % of the cases. Notably, more than half of the portal vein thrombosis patients (n = 81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p < 0.001), Child–Pugh Class B + C (p < 0.001), hepatocellular carcinoma (p = 0.01), previous upper gastrointestinal bleeding (p = 0.030) and older age (p = 0.012) were independently associated with portal vein thrombosis. Portal vein thrombosis is a frequent complication of cirrhosis, particularly in patients with moderate–severe liver failure. The apparent undertreatment of patients with portal vein thrombosis is a matter of concern and debate, which should be addressed by planning interventional trials especially with newer oral anticoagulants. Clinicaltrials.gov identifier NCT01470547.
Violi F.; Corazza R.G.; Caldwell S.H.; Perticone F.; Gatta A.; Angelico M.; Farcomeni A.; Masotti M.; Napoleone L.; Vestri A.; Raparelli V.; Basili S.; Palasciano G.; D'Alitto F.; Palmieri V.O.; Santovito D.; Di Michele D.; Croce G.; Sacerdoti D.; Brocco S.; Fasolato S.; Cecchetto L.; Bombonato G.; Bertoni M.; Restuccia R.; Andreozzi P.; Liguori L.M.; Perticone F.; Caroleo B.; Perticone M.; Staltari O.; Manfredini R.; De Giorgi A.; Averna M.; Giammanco A.; Granito A.; Pettinari I.; Marinelli S.; Bolondi L.; Falsetti L.; Salvi A.; Durante-Mangoni E.; Cesaro F.; Farinaro V.; Ragone E.; Morana I.; Andriulli A.; Ippolito A.; Iacobellis A.; Niro G.; Merla A.; Raimondo G.; Maimone S.; Cacciola I.; Varvara D.; Drenaggi D.; Staffolani S.; Picardi A.; Vespasiani-Gentilucci U.; Galati G.; Gallo P.; Davi G.; Schiavone C.; Santilli F.; Tana C.; Licata A.; Soresi M.; Bianchi B.G.; Carderi I.; Pinto A.; Tuttolomondo A.; Ferrari G.; Gresele P.; Fierro T.; Morelli O.; Laffi G.; Romanelli R.G.; Arena U.; Cristina S.; Gasbarrini A.; Gargovich M.; Zocco Z.M.; Riccardi L.; Ainora M.E.; Capeci W.; Martino M.G.; Lorenzo N.; Cavallo M.; Frugiuele P.; Greco A.; Pietrangelo A.; Ventura P.; Cuoghi C.; Marcacci M.; Serviddio G.; Vendemiale G.; Villani R.; Gargano R.; Vidili G.; Di Cesare V.; Masala M.; Delitala G.; Invernizzi P.; Di Minno G.; Tufano A.; Purrello F.; Privitera G.; Forgione A.; Curigliano V.; Senzolo M.; Rodriguez-Castro K.-I.; Giannelli G.; Serra C.; Neri S.; Pignataro P.; Rizzetto M.; Debernardi V.W.; Svegliati B.G.; Bergamaschi G.; Masotti M.; Costanzo F.; Angelico F.; Del Ben M.; Napoleone L.; Polimeni L.; Raparelli V.; Talerico G.; Proietti M.; Romiti G.F.; Ruscio E.; Toriello F.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/720233
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