Haemostatic Profile of Patients with Chronic Liver Disease- its Correlation with Severity and Outcome

Rai,; Dhameja, Neeraj; Kumar, Sandip; Shukla, Jyoti; Singh, Rajan; Dixit, Vinod Kumar

doi:10.7860/jcdr/2017/24975.10451

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…As a result, they have a greater risk of bleeding [26]. However, the long-held belief that people with CLD had a tendency to bleed has been disproved [27]. This is usually true in gastrointestinal spontaneous bleeding; however, we now know that this is due to portal hypertension, not a drop in plasma factors initiating the coagulation cascade, as previously thought [28].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of portal vein thrombosis in cirrhotic patients with and without hepatocellular carcinoma

Serag

Eysa

2022

Egypt Liver Journal

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Background The levels of Annexin A5 (Annexin V) were measured in patients with and without HCC who had liver cirrhosis. These patients were followed for 12 months to determine the incidence of PVT and to determine the role of Annexin V in the diagnosis of PVT. Our goal was to look at the value of Annexin A5, platelet count, spleen size, portal flow velocity, portal vein width, Fibrosis 4, and APRI score in these individuals to see if they might be used as PVT markers. Methods Between March 2017 and August 2018, ninety-one HCV patients with cirrhosis with and without HCC, as well as a control group of twenty healthy people, were included in this longitudinal study at the NHTMRI. The blood anxA5 level was determined using a commercial Hyphen BioMed immunoassay using Stat Fax 4700’s Microstrip Reader l. Results Cirrhotic patients with and without HCC who developed PVT had higher Annexin A5 scales (5.75 + 0.18), compared to cirrhotic patients who did not develop PVT (3.63 + 1.08 (P 0.001). PVT was 20% in all cirrhotic patients after a year, 15% in cirrhotic patients without HCC, and 25% in cirrhotic patients with HCC. Cirrhotic patients who had PVT throughout the follow-up period had greater AnxA5 serum levels than cirrhotic patients who did not develop PVT. Conclusions In all cirrhotic patients, AnxA5 level, platelet count, spleen size, portal flow velocity, portal vein diameter, and Fibrosis 4 score might be employed as markers for PVT development.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of portal vein thrombosis in cirrhotic patients with and without hepatocellular carcinoma

Serag

Eysa

2022

Egypt Liver Journal

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“…According to some studies, the abnormalities in the hyperfibrinolitic process correlate with the CTP score and are more prevalent in the elderly and in patients with decompensated cirrhosis [146,147]. Primary hyperfibrinolysis occurs due to the increased concentration of t-PA (as a consequence of impaired hepatic clearance) and decreased concentration or functionality of antiplasmin and other plasminogen activator inhibitors [148][149][150][151], which leads to an increased conversion of plasminogen to plasmin [152]. The secondary hyperfibrinolysis develops as a continuum of an emphasized coagulation, most commonly within DIC.…”

Section: The Relation Between Endothelial Dysfunction Systemic Inflamentioning

confidence: 99%

Endothelial Dysfunction and Systemic Inflammation in the Pathogenesis and Progression of Portal Hypertension

Ristovska¹

2021

Portal Hypertension - Recent Advances

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Hepatic and extrahepatic factors contribute to mortality related to liver cirrhosis and therefore much research is still to be done in order to understand the condition thoroughly and to possibly intervene in the process. It is considered that the currently applied prognostic scores are not ideal mortality predictors. On the other hand, recent scientific concepts have revealed the significant contributing role of endothelial dysfunction and of systemic inflammation in the pathogenesis of portal hypertension. Consequently, these concepts are inevitably leading towards proposing and validating new prognostic indicators in cirrhotic patients. Von-Willebrand factor as an indicator of endothelial dysfunction and C-reactive protein as a surrogate marker of systemic inflammation and several other parameters and biological markers have been emerging as a relevant and potentially useful prognostic indicators. Also, the coagulopathy associated to liver disease is in close relation with these entities and still an important research topic. Despite the promising data regarding their prognostic potential, additional research is needed in order to define and validate their value more precisely in clinical and prognostic settings.

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“…Існуючі наукові дані про стан гемостазу у пацієнтів з цирозом печінки та ФП досить обмежені, і ми зробили перші кроки у розумінні цього складного процесу, але отримані дані щодо стану гемостазу у хворих з цирозом печінки відповідають раніше отриманим даним інших авторів (Dhanunjaya, U. Anand & CV Anand, 2013;Saner & Kirchner, 2016;Rai, Dhameja & Kumar, 2017).…”

Section: здорові N=20unclassified

Assessment of Coagulation Profile in Patients With Liver Cirrhosis and Atrial Fibrillation

Байло

Shipulin²,

Чернявський³

et al. 2021

USMYJ

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The comorbid course of liver cirrhosis and atrial fibrillation causes higher levels of hospitalizations, mortality and ischemic stroke. According to current data, hemostasis in patients with liver cirrhosis is in a rebalanced dynamic state, but there are no data on the effect of atrial fibrillation on the hemostasis in patients with liver cirrhosis. Aims of the study. To assess abnormalities in primary, secondary haemostasis and fibrinolytic system in patients with liver cirrhosis and atrial fibrillation by using standard laboratory coagulation parameters and to investigate their changes depending on the stage of liver cirrhosis A, B, C according to Child-Pugh score. Materials and methods. A cross-sectional prospective study was conducted with the inclusion of 106 patients aged 42 to 83 years: group I (n = 70) - with liver cirrhosis and atrial fibrillation, II (n = 36) - with liver cirrhosis, which were distributed depending on the Child-Pugh score stages of cirrhosis and 20 healthy individuals. The levels of platelets, activated partial thromboplastin time, international normalized ratio, prothrombin time, thrombin time, fibrinogen, D-dimer were assessed on a Steellex M200 coagulometer. Statistical analysis (IBM SPSS Statistics) was performed. Results. The level of platelets in patients of group I was reduced by 37.4% (200 ± 8.33 vs. 274.7 ± 3.4; p,000.001), an activated partial thromboplastin time was prolonged by 38.6% (44.35 ± 1.39 vs. 32.01 ± 0.63, p˂0.001), prothrombin time was prolonged by 73.5% (19.4 ± 0.87 vs. 11.18 ± 0.53, p˂0.001), thrombin time was prolonged by 2.07 (25, 7 ± 1.31 vs. 12.4 ± 0.66, p˂0.001), the international normalized ratio was increased by 24.3% (1.38 ± 0.04 vs.1.11 ± 0.01, p˂0.001) compared to control. The fibrinogen level was 20.9% higher (4.17 ± 0.17 vs. 3.45 ± 0.11, p˂0.001) than in control group and was 83.7% higher (4.17 ± 0.17 vs. 2.27 ± 0.13, p˂0.001) than in group II. The D-dimer level was 83% higher than in control (675 ± 22.3 vs. 368.8 ± 21.85, p˂0.001) and 44% higher (675 ± 22.3 vs. 469 ± 37.18, p ˂0.001) compared with group II. Conclusions. In patients with liver cirrhosis and atrial fibrillation abnormalities of primary hemostasis are detected due to decrease of platelets on the background of portal hypertension. At the secondary stage of hemostasis indicators of external and internal coagulation mechanisms are prolonged due to the reduced synthesis of coagulation factors by the liver. Increased level of fibrinogen is determined at the stage of compensated and subcompensated cirrhosis with a gradual decrease at the stage of decompensation. The high activity of the fibrinolytic system is observed due to increase in the D-dimer levels, which may indicate a prothrombotic state in these patients.

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Haemostatic Profile of Patients with Chronic Liver Disease- its Correlation with Severity and Outcome

Abstract: Introduction:The liver plays an important role in the haemostatic system as it synthesizes the majority of coagulation factors and fibrinolytic proteins.Aim: The present study was planned to determine the range of haemostatic defects in patients of chronic liver diseases.

Cited by 7 publications

References 21 publications

Diagnosis of portal vein thrombosis in cirrhotic patients with and without hepatocellular carcinoma

Diagnosis of portal vein thrombosis in cirrhotic patients with and without hepatocellular carcinoma

Endothelial Dysfunction and Systemic Inflammation in the Pathogenesis and Progression of Portal Hypertension

Assessment of Coagulation Profile in Patients With Liver Cirrhosis and Atrial Fibrillation

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