Direct-acting Oral Anticoagulants in Liver Cirrhosis: What is the Current Status?
Pp. 234-247 (14)
In the last few years, the coagulation abnormalities associated with liver
cirrhosis were better characterized, concluding that the patients with liver cirrhosis are
predisposed to thrombotic or bleeding complications. Portal vein thrombosis is the
most frequent thrombotic event, associated with liver cirrhosis. Atrial fibrillation is also
a frequent comorbidity in patients with liver cirrhosis associated with higher risks of
embolic complications, needing an anticoagulant prophylactic treatment. Direct-acting
oral anticoagulants (DOACs), warfarin, unfractionated heparin or low weight
molecular heparin are not always efficient in liver cirrhosis. According to recent
studies, DOACs are relatively safe in Child-Pugh class A or B liver cirrhosis for the
treatment of acute portal vein thrombosis or prevention of embolic events in patients
associating atrial fibrillation. All DOACs are contraindicated in patients with ChildPugh class C liver cirrhosis.
Anticoagulation, Atrial fibrillation, Direct-acting oral anticoagulants,
Liver cirrhosis, Portal vein thrombosis, Thrombosis.