title: Thrombotic risk factors in patients with liver cirrhosis: correlation with MELD scoring system and portal vein thrombosis development.
abstract: OBJECTIVE
  Prognostic scores currently used in cirrhotic patients do not include thrombotic risk factors (TRFs). Predicting factors of portal vein thrombosis (PVT) development are still unknown. We wanted to describe TRFs as a function of liver disease severity using the MELD score and assess the role of local and systemic TRFs as predictors of PVT development in cirrhotic patients.
  
  
  METHODS
  One hundred consecutive patients with liver cirrhosis were included in the study. TRFs, D-dimers, MELD score, portal vein patency and flow velocity were evaluated in all subjects at baseline and every 6 months thereafter. Variables able to predict PVT development within 1 year were identified by means of multiple logistic regression.
  
  
  RESULTS
  The plasma levels of protein C and antithrombin were lower and the concentration of D-dimers was higher in patients with advanced disease. Plasma levels of antithrombin, protein C and protein S resulted significantly lower in PVT group at univariate analysis, but reduced portal vein flow velocity was the only variable independently associated with PVT development.
  
  
  CONCLUSIONS
  Lower concentrations of natural coagulation inhibitors are frequently detected in patients with liver cirrhosis. A reduced portal flow velocity seems to be the most important predictive variable for PVT development in patients with cirrhosis.
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Gemelli Hospital, Largo A. Gemelli 8, 00168 Rome, Italy. mariaazocco@hotmail.com
authors.forename: Maria Assunta
authors.initials: MA
authors.lastname: Zocco
authors.forename: Enrico
authors.initials: E
authors.lastname: Di Stasio
authors.forename: Raimondo
authors.initials: R
authors.lastname: De Cristofaro
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Novi
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Ainora
authors.forename: Francesca
authors.initials: F
authors.lastname: Ponziani
authors.forename: Laura
authors.initials: L
authors.lastname: Riccardi
authors.forename: Stefano
authors.initials: S
authors.lastname: Lancellotti
authors.forename: Angelo
authors.initials: A
authors.lastname: Santoliquido
authors.forename: Roberto
authors.initials: R
authors.lastname: Flore
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Gian Lodovico
authors.initials: GL
authors.lastname: Rapaccini
authors.forename: Paolo
authors.initials: P
authors.lastname: Tondi
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Gasbarrini
authors.forename: Raffaele
authors.initials: R
authors.lastname: Landolfi
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000378:metabolism; D001783:Blood Flow Velocity; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology; D011379:Prognosis; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000991:Antithrombins; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D017293:Protein S; C036309:fibrin fragment D