Most Read Articles
Yesterday
Long-term use of benzodiazepines is independently associated with lower diastolic and systolic blood pressure in ambulatory blood pressure monitoring (ABPM) among older but not younger patients, a study has found.
3 days ago
There appears to be a paradox in the context of smoking and the risk of psoriatic arthritis (PsA), such that current smoking increases the risk of developing PsA in the general population but protects against the same risk among patients with psoriasis, according to a study.
4 days ago
Moderate increases in physical activity levels may translate to significant reductions in both fasting glucose and HbA1c, a study has found.
Pearl Toh, 14 Nov 2017
Performing percutaneous coronary intervention (PCI) on culprit lesion only, rather than a multivessel PCI, reduces the 30-day composite risk of death or severe renal failure in patients with acute myocardial infarction (MI) complicated by cardiogenic shock and multivessel disease, according to the CULPRIT-SHOCK* study presented at the TCT 2017 Congress held in Denver, Colorado, US.

Risk-benefit profile of VKA in cirrhotic patients with portal vein thrombosis

13 Nov 2017

Vitamin K antagonist (VKA) may increase the risk of minor bleeding in cirrhotic patients receiving anticoagulants for portal vein thrombosis (PVT), according to a study. However, this risk is compensated for by the ability of VKA to increase portal hypertension-related, event-free and transplantation-free survival of patients with PVT recanalization.

The retrospective study included 63 cirrhotic patients who received anticoagulants for a first detection of non-neoplastic PVT (PVT group) and 160 noncirrhotic patients with venous thromboembolism (VTE group) treated with VKA. Four-year data on bleeding events were compared between these two patient groups.

Additionally, data from 139 cirrhotic patients who did not receive VKAs (control group) were analysed for portal hypertension-related events. Survival analysis facilitated estimation of the effects of VKA in PVT patients as compared with controls.

The VTE and PVT groups were comparable with respect to age, sex and time in the therapeutic range, but patients with VTE received a longer duration of VKA treatment (31.1 vs 23.3 months; p=0.002). Major and minor bleeding occurred with greater frequency in the PVT group than in the VTE group (major: 24 vs 7 percent; p=0.012; minor: 29 vs 19 percent; p=0.024).

In particular, patients with PVT had a higher rate of major bleeding from the upper-GI tract compared with those with VTE (p=0.019), although there were no significant differences in other types of major bleeding (p=0.376). When compared with controls, the rate of upper-GI bleeding in PVT patients was similar.

In the PVT group, complete recanalization was independently associated with increased portal hypertension-related event-free and transplantation-free survival times.

Researchers noted that portal hypertension, rather than anticoagulants, could explain the difference in risk of major bleeding between patients with PVT and those with VTE.

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Most Read Articles
Yesterday
Long-term use of benzodiazepines is independently associated with lower diastolic and systolic blood pressure in ambulatory blood pressure monitoring (ABPM) among older but not younger patients, a study has found.
3 days ago
There appears to be a paradox in the context of smoking and the risk of psoriatic arthritis (PsA), such that current smoking increases the risk of developing PsA in the general population but protects against the same risk among patients with psoriasis, according to a study.
4 days ago
Moderate increases in physical activity levels may translate to significant reductions in both fasting glucose and HbA1c, a study has found.
Pearl Toh, 14 Nov 2017
Performing percutaneous coronary intervention (PCI) on culprit lesion only, rather than a multivessel PCI, reduces the 30-day composite risk of death or severe renal failure in patients with acute myocardial infarction (MI) complicated by cardiogenic shock and multivessel disease, according to the CULPRIT-SHOCK* study presented at the TCT 2017 Congress held in Denver, Colorado, US.