Evaluation of Low-Molecular-Weight Heparin for Treatment of Portal Vein Thrombosis in Liver Cirrhosis Patients
Abstract
:1. Introduction
2. Methods and Materials
2.1. Patients
2.2. Anticoagulation Protocol
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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No Response (n = 41) | Response (n = 80) | p | ||||
---|---|---|---|---|---|---|
N (or Mean) | % (or ±S.D) | N (or Mean) | % (or ±S.D) | |||
Sex | Female | 11 | 39.3 | 17 | 60.7 | 0.491 |
Male | 30 | 32.3 | 63 | 67.7 | ||
Age (year) | <65 | 25 | 41.7 | 35 | 58.3 | 0.073 |
≥65 | 16 | 26.2 | 45 | 73.8 | ||
Height (cm) | <165 | 19 | 34.5 | 36 | 65.5 | 0.984 |
≥165 | 22 | 34.4 | 42 | 65.6 | ||
Body weight (kg) | <65 | 25 | 38.5 | 40 | 61.5 | 0.281 |
≥65 | 16 | 29.1 | 39 | 70.9 | ||
Platelet count (×103/mm3) a | 73.70 | 47.23 | 89.26 | 54.18 | 0.122 | |
Prothrombin time (INR) a | 1.26 | 0.17 | 1.22 | 0.15 | 0.269 | |
Cause of LC | Alcoholic | 4 | 36.3 | 7 | 63.6 | 0.725 |
Hepatitis B or C | 31 | 32.3 | 65 | 37.7 | ||
Others | 6 | 42.9 | 8 | 57.1 | ||
Combined HCC | No | 11 | 35.5 | 20 | 64.5 | 0.827 |
Yes | 30 | 33.3 | 60 | 66.7 | ||
TACE or RFA | No | 13 | 37.1 | 22 | 62.9 | 0.629 |
Yes | 28 | 32.6 | 58 | 67.4 | ||
History of variceal bleeding | No | 11 | 17.5 | 52 | 82.5 | <0.001 |
Yes | 30 | 51.7 | 28 | 48.3 | ||
Esophageal/gastric varices | No | 6 | 25.0 | 18 | 75.0 | 0.304 |
Yes | 35 | 36.1 | 62 | 63.9 | ||
Extensive of thrombus | Partial | 36 | 31.9 | 77 | 68.1 | 0.077 |
Complete | 5 | 62.5 | 3 | 37.5 | ||
Status of thrombus | Newly developed | 11 | 20.4 | 43 | 79.6 | 0.019 |
Stationary | 1 | 50.0 | 1 | 50.0 | ||
Progressive | 29 | 44.6 | 36 | 55.4 | ||
Child-Pugh classification | A | 17 | 26.6 | 47 | 73.4 | 0.071 |
B or C | 24 | 42.1 | 33 | 57.9 | ||
Duration from diagnosis of PVT to dalteparin treatment (month) | <6 | 20 | 25.6 | 58 | 74.4 | 0.010 |
≥6 | 21 | 48.8 | 22 | 51.1 | ||
Dosing regimen | Fixed | 21 | 45.7 | 25 | 54.3 | 0.032 |
kg based | 20 | 26.7 | 55 | 73.3 |
Characteristics | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | |
---|---|---|---|
Male | 2.134 (0.663–6.870) | ||
Age (year) | ≥65 | 2.250 (0.837–6.050) | |
Child–Pugh classification | A | 2.141 (0.854–5.371) | 2.232 (0.920–5.412) |
History of variceal bleeding | No | 4.278 (1.706–10.728) ** | 4.633 (1.879–11.426) ** |
Extensive of thrombus | Partial | 4.070 (0.687–24.126) | 4.982 (0.927–26.783) |
Status of thrombus | Newly developed | 2.958 (0.961–9.105) | 3.159 (1.236–8.076) * |
Stationary | 8.09 (0.250–261.697) | 4.297 (0.206–89.803) | |
Progressive | 0 | ||
Duration from diagnosis of PVT to dalteparin treatment (month) | <6 | 1.183 (0.388–3.604) | |
Dosing regimen | Kg-based | 2.310 (1.066–5.007) * | 2.597 (1.057–6.383) * |
No Relapse (n = 48) | Relapse (n = 32) | p | ||||
---|---|---|---|---|---|---|
N (or Mean) | % (or ±S.D) | N (or Mean) | % (or ±S.D) | |||
Sex | Female | 9 | 52.9 | 8 | 47.1 | 0.503 |
Male | 39 | 61.9 | 24 | 38.1 | ||
Age (year) | <65 | 24 | 68.6 | 11 | 31.4 | 0.168 |
≥65 | 24 | 53.3 | 21 | 46.7 | ||
Platelet count (×103/mm3) a | 96.44 | 53.36 | 78.50 | 54.47 | 0.148 | |
Prothrombin time (INR) a | 1.20 | 0.14 | 1.26 | 0.15 | 0.103 | |
Combined HCC | No | 9 | 45 | 11 | 55 | 0.114 |
Yes | 39 | 65 | 21 | 35 | ||
TACE or RFA | No | 11 | 50 | 11 | 50 | 0.261 |
Yes | 37 | 63.8 | 21 | 36.2 | ||
History of variceal bleeding | No | 33 | 63.5 | 19 | 36.5 | 0.389 |
Yes | 15 | 53.6 | 13 | 46.4 | ||
Esophageal/gastric varices | No | 12 | 55.7 | 6 | 33.3 | 0.512 |
Yes | 36 | 58.1 | 26 | 41.9 | ||
Thrombus filling | Partial | 47 | 61 | 30 | 39 | 0.337 |
Complete | 1 | 33.3 | 2 | 66.7 | ||
Status of thrombus | Newly developed | 26 | 60.5 | 17 | 39.5 | 0.700 |
Stationary | 1 | 100 | 0 | 0 | ||
Progressive | 21 | 58.3 | 15 | 41.7 | ||
Child–Pugh classification | A | 26 | 55.3 | 21 | 44.7 | 0.308 |
B or C | 22 | 66.7 | 11 | 33.3 | ||
Duration from diagnosis of PVT to dalteparin treatment (month) | <3 | 35 | 70.0 | 15 | 30.0 | 0.018 |
≥3 | 13 | 43.3 | 17 | 56.7 | ||
Duration from diagnosis of PVT to dalteparin treatment (month) | <6 | 40 | 69.0 | 18 | 31.0 | 0.008 |
≥6 | 8 | 36.4 | 14 | 63.6 | ||
Dosing regimen | Fixed | 18 | 72.0 | 7 | 28.0 | 0.140 |
Kg-based | 30 | 54.5 | 25 | 45.5 | ||
Duration of therapy (month) | <6 | 15 | 78.9 | 4 | 21.1 | 0.645 |
≥6 | 33 | 54.1 | 28 | 45.9 |
Characteristics | Unadjusted OR (95% CI) | Model I | Model II | |
---|---|---|---|---|
Adjusted OR (95% CI) | Adjusted OR (95% CI) | |||
Male | 0.692 (0.235–2.038) | |||
Age (year) | ≥65 | 1.909 (0.758–4.806) | ||
Duration from diagnosis of PVT to dalteparin treatment (month) | ≥3 | 3.051 (1.190–7.827) * | 3.051 (1.190–7.827) * | |
Duration from diagnosis of PVT to dalteparin treatment (month) | ≥6 | 3.889 (1.386–10.910) * | 3.889 (1.386–10.910) * |
Characteristics | Fixed Dosing Regimen (n = 46) | Kg-Based Dosing Regimen (n = 75) | p | ||||
---|---|---|---|---|---|---|---|
N | % | N | % | ||||
Treatment response | Yes | Complete | 10 | 33.3 | 20 | 33.7 | 0.032 |
Partial | 15 | 30.0 | 35 | 70.0 | |||
No | Stable or progressive | 21 | 51.2 | 20 | 48.8 | ||
Bleeding | Yes | 3 | 21.4 | 11 | 78.6 | 0.174 | |
No | 43 | 40.2 | 64 | 59.8 | |||
Sex | Female | 10 | 35.7 | 18 | 64.3 | 0.775 | |
Male | 36 | 38.7 | 57 | 61.3 | |||
Age (year) | <65 | 28 | 46.7 | 32 | 53.3 | 0.052 | |
≥65 | 18 | 29.5 | 43 | 70.5 | |||
Child-Pugh classification | A | 25 | 39.1 | 39 | 60.9 | 0.802 | |
B or C | 21 | 36.8 | 36 | 63.2 | |||
Combined HCC | No | 13 | 41.9 | 18 | 58.1 | 0.602 | |
Yes | 33 | 36.7 | 57 | 63.3 | |||
TACE or RFA | No | 14 | 40.0 | 21 | 60.0 | 0.774 | |
Yes | 32 | 37.2 | 54 | 62.8 | |||
History of variceal bleeding | No | 24 | 38.1 | 39 | 61.9 | 0.985 | |
Yes | 22 | 37.9 | 36 | 62.1 | |||
Esophageal/gastric varices | No | 11 | 45.8 | 13 | 54.2 | 0.378 | |
Yes | 35 | 36.1 | 62 | 63.9 | |||
Thrombus filling | Partial | 42 | 37.2 | 71 | 62.8 | 0.470 | |
Complete | 4 | 50.0 | 4 | 50.0 | |||
Status of thrombus | Newly developed | 19 | 35.2 | 35 | 64.8 | 0.813 | |
Stationary | 1 | 50.0 | 1 | 50.0 | |||
Progressive | 26 | 40.0 | 39 | 60.0 |
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Han, J.M.; Koh, Y.; Kim, S.H.; Suh, S.Y.; Cho, Y.S.; Lee, J.-H.; Yu, S.J.; Yoon, J.-H.; Gwak, H.S. Evaluation of Low-Molecular-Weight Heparin for Treatment of Portal Vein Thrombosis in Liver Cirrhosis Patients. Medicina 2023, 59, 292. https://doi.org/10.3390/medicina59020292
Han JM, Koh Y, Kim SH, Suh SY, Cho YS, Lee J-H, Yu SJ, Yoon J-H, Gwak HS. Evaluation of Low-Molecular-Weight Heparin for Treatment of Portal Vein Thrombosis in Liver Cirrhosis Patients. Medicina. 2023; 59(2):292. https://doi.org/10.3390/medicina59020292
Chicago/Turabian StyleHan, Ji Min, Youngil Koh, Sung Hwan Kim, Sung Yun Suh, Yoon Sook Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan Yoon, and Hye Sun Gwak. 2023. "Evaluation of Low-Molecular-Weight Heparin for Treatment of Portal Vein Thrombosis in Liver Cirrhosis Patients" Medicina 59, no. 2: 292. https://doi.org/10.3390/medicina59020292