Prediction of oesophageal varices in hepatic cirrhosis by simple serum non-invasive markers: Results of a multicenter, large-scale study

Sebastiani, Giada; Tempesta, Diego; Fattovich, Giovanna; Castéra, Laurent; Halfon, Philippe; Bourlière, Marc; Noventa, Franco; Angeli, Paolo; Saggioro, A.; Alberti, Alfredo

doi:10.1016/j.jhep.2010.04.019

Cited by 126 publications

(114 citation statements)

References 28 publications

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“…Rev esp enfeRm Dig 2017;109(1): [17][18][19][20][21][22][23][24][25] hemoglobin, platelets, neutrophils, albumin, and bilirubin, as well as in the VL. No differences were found in the INR value (Table II).…”

Section: Hypertension In Cirrhotic Hcv Patients Treated With Antiviramentioning

confidence: 99%

Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy

et al. 2016

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Background and aims:The regression of liver fibrosis and portal hypertension (PH) and their influence on the natural history of compensated hepatitis C virus (HCV)-related cirrhosis has not been studied previously. Our objective was to evaluate the influence of sustained virologic response (SVR) on the portal pressure gradient (HVPG) and non-invasive parameters of PH and prognostic factors of response.Methods: Sixteen patients with compensated HCV genotype 1-related cirrhosis with PH (HVPG > 6 mmHg) without beta-blocker therapy were considered as candidates for PEGα2a + RBV + BOC (48 weeks; lead-in and accepted stopping rules). A hemodynamic study and Fibroscan ® were performed at baseline, at eight weeks and, in the case of SVR, 24 weeks after treatment. In each hemodynamic study, serum samples were analyzed for inflammatory biomarkers associated with PH.Results: In eight cases, SVR was obtained; five patients relapsed, and treatment was stopped early for non-response to lead in (one case) and a decrease of < 3 log at week 8 (two patients).

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Section: Hypertension In Cirrhotic Hcv Patients Treated With Antiviramentioning

confidence: 99%

Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy

et al. 2016

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“…The etiology of thrombocytopenia is multifactorial, including increased platelet sequestration in the spleen in congestive splenomegaly, which is caused by portal hypertention, decreased production of thrombopoietin, as well as platelet destruction as a result of immune processes or antibodies. (21) There was a significant difference in mean platelet count between the group of large esophageal varices and the group of small esophageal varices, with a significantly lower mean platelet count among large esophageal varices as compared with small esophageal varices. This is in line with a previous study reporting that low platelet count was an independent risk factor or predictor for the presence of esophageal varices and their size.…”

Section: Discussionmentioning

confidence: 82%

Forns index as a useful noninvasive predictor of esophageal varices in liver cirrhosis

Siregar

Dairi

Siregar

2016

UnivMed

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“…Some simple serum non-invasive markers such as the Lok index, the Forns' index or the platelet count/spleen diameter ratio have shown a good performance for diagnosis varices. Remarkably, in a recent large-scale multicenter study a combination of a Lok index (cutoff 1.5) and a Forns' index (cutoff 8.8) had a high negative predictive value for excluding presence of clinically relevant varices that would benefit from primary prophylaxis (large varices or small varices with red signs or in Child-Pugh class C patients) [58]. The platelet count/spleen diameter ratio is a promising index recently proposed, which has shown a 100% negative predictive value for excluding any grade varices [59].…”

Section: Detection Of Varices and Prognostic Markers For Varicesmentioning

confidence: 98%

Prognostic Markers in Patients with Cirrhosis and Portal Hypertension Who Have Not Bled

et al. 2011

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Abstract. Prognostic markers of compensated cirrhosis should mainly investigate factors involved with progression to decompensation because death in cirrhosis is related with decompensation. Portal hypertension plays a crucial role in the pathophysiology of most complications of cirrhosis. Accordingly, HVPG monitoring has strong prognostic value. An HVPG 10 mmHg determines a significantly higher risk of developing decompensation. Esophageal varices also can develop when the HVPG is 10 mmHg, although an HVPG 12 mmHg is required for variceal bleeding to occur. Monitoring the changes induced by the treatment of portal hypertension on HVPG, provides strong prognostic information. In compensated cirrhosis hemodynamic response is appropriate when the HVPG decreased to < 10 mmHg or by > 10% from baseline, because the incidence of complications such as bleeding or ascites significantly decrease when these targets are achieved. Whether serum markers, such as the FibroTest, they, may be valuable to predict decompensation should be established. Transient Elastography is a promising technique that has shown an excellent accuracy to detect severe portal hypertension. However, whether it can adequately determine clinically significant portal hypertension, and risk of developing varices and decompensation, should be established. Magnetic Resonance Elastography is also promising.

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Prediction of oesophageal varices in hepatic cirrhosis by simple serum non-invasive markers: Results of a multicenter, large-scale study

Cited by 126 publications

References 28 publications

Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy

Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy

Forns index as a useful noninvasive predictor of esophageal varices in liver cirrhosis

Prognostic Markers in Patients with Cirrhosis and Portal Hypertension Who Have Not Bled

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