Impact of Treatment Response to Anticoagulant Therapy on Liver-Related Events in Patients With Cirrhosis and Portal Vein Thrombosis
Research article published in Hepatology research : the official journal of the Japan Society of Hepatology (2026)
Abstract
AIM: The effect of treatment response to anticoagulant therapy on prognosis of patients with cirrhosis and portal vein thrombosis (PVT) remains unclear. METHODS: Forty-one patients with cirrhosis and first PVT treated with intravenous anticoagulant therapy between January 2015 and April 2018 at 10 Japanese hospitals were included. Treatment response was defined based on change in size of PVT after anticoagulant therapy as the following: complete response (CR, 0%), partial response (PR, ≤ 50%), stable disease (SD, 51%-100%), and progressive disease (PD, ≥ 101%). CR and PR were combined as the effective group and SD and PD formed as the ineffective group. RESULTS: The median age was 69 years, and 56% of the patients had Child-Pugh class B. Overall, 5 (12%) achieved CR, 22 (54%) achieved PR, 12 (29%) had SD and 2 (5%) had PD. During a median follow-up of 31.8 months from the date of assessment of treatment response, 17 patients died. The overall survival rates at 1- and 3-year were 82.5% and 65.1%, respectively. In the multivariate analysis, the model for end-stage liver disease-Na score was significantly associated with overall survival, whereas treatment response was not significant. Twenty-five patients experienced liver-related events with hospitalization, and the 3-year cumulative rate of liver-related events was 63.9%. In the multivariate analysis, treatment response was significantly associated with liver-related events. The 3-year cumulative rates of liver-related events were 56.7% and 75.5% in the effective and ineffective groups, respectively (p = 0.008). CONCLUSIONS: Among patients with cirrhosis, treatment response to anticoagulant therapy for PVT correlated with the incidence of liver-related hospitalization events.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
The effect of treatment response to anticoagulant therapy on prognosis of patients with cirrhosis and portal vein thrombosis (PVT) remains unclear. Forty-one patients with cirrhosis and first PVT treated with intravenous anticoagulant therapy between January 2015 and April 2018 at 10 Japanese hospitals were included.
Warum dies für die Hirudotherapie relevant ist
Diese multizentrische japanische Studie mit 41 Patienten mit Zirrhose und einer ersten Pfortaderthrombose, die eine intravenöse Antikoagulation erhielten, bewertete das Behandlungsansprechen anhand der Veränderung der Thrombusgröße und stellte fest, dass das Ansprechen zwar das Gesamtüberleben nicht signifikant vorhersagte (dieses wurde stattdessen vom MELD-Na-Score bestimmt), ein wirksames antikoagulantes Ansprechen jedoch signifikant mit weniger leberbezogenen Hospitalisierungsereignissen assoziiert war (kumulative 3-Jahres-Rate 56,7% bei Respondern gegenüber 75,5% bei Non-Respondern, P = 0,008). Für das klinische Evidenzbild der Hirudotherapie ist sie relevant als realer Blick darauf, wie sich die erfolgreiche Auflösung eines venösen Thrombus in patientenrelevante Ergebnisse bei einer fragilen, blutungsanfälligen zirrhotischen Population übersetzt — die Art von Nutzen-Risiko-Abwägung, die jede antithrombotische Strategie respektieren muss. Die Einschränkungen bestehen darin, dass es sich um eine kleine Beobachtungskohorte (41 Patienten in 10 Krankenhäusern) unter konventioneller intravenöser Antikoagulation und nicht Hirudotherapie handelt und die Überlebensanalyse unterpowert war, sodass die Assoziation mit leberbezogenen Ereignissen hypothesengenerierend und nicht bestätigend ist.
Zitation
Impact of Treatment Response to Anticoagulant Therapy on Liver-Related Events in Patients With Cirrhosis and Portal Vein Thrombosis.
Maeda A et al. · Hepatology research : the official journal of the Japan Society of Hepatology, 2026
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