Do Anticoagulants Improve Survival in Cirrhosis-Portal Vein Thrombosis?

Individuals with cirrhosis and portal vein thrombosis (PVT) may be able to improve their chance of survival by taking an anticoagulant treatment, results of a new study show.

Because PVT is a frequent complication of cirrhosis and anticoagulant therapy in that patient population is controversial, the researchers sought to determine the impact of therapy. To do so, they analyzed data on 182 participants with both cirrhosis and PVT with at least 3 months of follow-up after PVT was first detected.

As prescribed by their physicians, 81 participants received anticoagulants and 101 did not.

Among those on anticoagulants, 46 had a decrease of the extension of the thrombosis by more than 50%—26 of those who did not receive anticoagulants experienced the same.

Recurrent thrombosis after ceasing anticoagulation therapy was observed in 17 of the 46 participants who underwent recanalization.

The treatment group also had higher and longer survival rates.

There were bleeding complications in 22 untreated participants and 16 treated participants with only 4 of those cases being related to the anticoagulants.

“Anticoagulant treatment is a safe and effective treatment leading to partial or complete recanalization of the portal venous system in 56.8% of cases, improving the survival of patients with cirrhosis and PVT,” the researchers concluded. “Discontinuation of the therapy is associated with a high rate of PVT recurrence.”

–Colleen Murphy

Reference:

Pettinari I, Vukotic R, Stefanescu H, et al. Clinical impact and safety of anticoagulants for portal vein thrombosis in cirrhosis. Am J Gastroenterol. 2019;114(2):258-266.https://www.nature.com/articles/s41395-018-0421-0.