NDLI: Thrombin generation measured as thrombin-antithrombin complexes predicts clinical outcomes in patients with cirrhosis.

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Thrombin generation measured as thrombin-antithrombin complexes predicts clinical outcomes in patients with cirrhosis.

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Thrombin generation measured as thrombin-antithrombin complexes predicts clinical outcomes in patients with cirrhosis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kalambokis, Georgios N. Oikonomou, Aikaterini Baltayiannis, Gerasimos Christou, Leonidas Kolaitis, Nikolaos I. Tsianos, Epameinondas V.
Description	Author Affiliation: 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.)
Abstract	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.
File Format	HTM / HTML
ISSN	13866346
Issue Number	3
Journal	Hepatology Research
Volume Number	46
e-ISSN	1872034X
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2016-03-01
Publisher Place	Netherlands
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Hepatology
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Hepatology

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