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Thrombin generation measured as thrombin-antithrombin complexes predicts clinical outcomes in patients with cirrhosis.
Kalambokis, Georgios N; Oikonomou, Aikaterini; Baltayiannis, Gerasimos; Christou, Leonidas; Kolaitis, Nikolaos I; Tsianos, Epameinondas V.
Afiliación
  • Kalambokis GN; 1st Division of Internal Medicine, Medical School.
  • Oikonomou A; Hematology Laboratory Unit of Molecular Biology, Medical School.
  • Baltayiannis G; Division of Gastroenterology, Medical School, University of Ioannina, Ioannina, Greece.
  • Christou L; 1st Division of Internal Medicine, Medical School.
  • Kolaitis NI; Hematology Laboratory Unit of Molecular Biology, Medical School.
  • Tsianos EV; 1st Division of Internal Medicine, Medical School.
Hepatol Res ; 46(3): E36-44, 2016 Mar.
Article en En | MEDLINE | ID: mdl-25847196
AIM: Hypercoagulability has been detected in patients with cirrhosis yet its clinical significance remains unclear. We investigated the association of hypercoagulability with clinical outcomes in patients with cirrhosis. METHODS: Thrombin-antithrombin (TAT) complexes as thrombin generation (TG) marker, D-dimer, antithrombin (AT), protein C, protein S, international normalized ratio (INR), activated partial thromboplastin time, fibrinogen, Child-Pugh class and Model for End-Stage Liver Disease (MELD) were evaluated. Two different multivariate analyses were performed: one not including MELD (model 1) and one including MELD and excluding INR (model 2). RESULTS: Eighty-one patients (Child-Pugh class A/B/C: 27/27/27) and 40 healthy subjects were enrolled. Only ΤΑΤ and AT were independently associated with increasing liver disease severity. Increased TAT levels and MELD score were significantly associated with ascites and varices at baseline. Independent predictors of follow-up events were: TAT and MELD score for new-onset ascites; TAT and AT for variceal bleeding (VB); TAT and AT for portal vein thrombosis (PVT); and TAT and MELD for mortality. TAT equaled MELD in mortality prediction at 12 and 18 months. TAT cut-offs at 5.35, 14.6, 13.5 and 9.25 ng/mL identified patient groups with significantly higher probability of new-onset ascites, VB, PVT and mortality, respectively. CONCLUSION: Increased TG is strongly correlated with portal hypertension-related complications, PVT and mortality in patients with cirrhosis. Measuring TG by TAT could enable risk stratification and institution of preventive strategies to improve clinical outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Hepatol Res Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Hepatol Res Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos