Journal Article

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

Angelico, Mario, Masotti, Michela, Caldwell, Stephen Hugh, Perticone, Francesco, Gatta, Angelo, Corazza, Roberto Gino, Napoleone, Laura, Farcomeni, Alessio, Raparelli, Valeria, Vestri, Annarita, Violi, Francesco, Basili, Stefania

2016

Overview

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.

• Publisher: Springer Milan,Springer Nature B.V
• Subject: Aged / Female / Humans / Im - Original / Internal Medicine / Italy - epidemiology / Liver - physiopathology / Liver Cirrhosis - complications / Liver Cirrhosis - epidemiology / Male / Medicine / Medicine & Public Health / Middle Aged / Multivariate Analysis / Portal Vein - physiopathology / Prevalence / Prospective Studies / Registries / Venous Thrombosis - epidemiology / Venous Thrombosis - etiology