What is New in Gastroenterology and Hepatology

What is New in Gastroenterology and Hepatology

Note: This book has been published under Bentham’s FAST TRACK OPEN ACCESS publication option upon the author’s request. The finalized book will be published soon.

Gastroenterology and hepatology represent dynamic fields of study and practice in internal medicine, with numerous innovations manifesting over the last 30 years. What is New in Gastroenterology and ...
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Direct-acting Oral Anticoagulants in Liver Cirrhosis: What is the Current Status?

Pp. 234-247 (14)

DOI: 10.2174/9781681087870121010031

Author(s): Anca Trifan*, Irina Gîrleanu

Abstract

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.

Keywords:

Anticoagulation, Atrial fibrillation, Direct-acting oral anticoagulants, Liver cirrhosis, Portal vein thrombosis, Thrombosis.