Abstract
The liver represents the site of synthesis of most procoagulant and anticoagulant factors, fibrinolytic proteins and thrombopoetin while being also involved in the clearance of hemostatic and fibrinolyic proteins. Therefore in patients with liver insufficiency a great variety of disturbances can be documented resulting however in a new “rebalanced” hemostatic system with a labile equilibrium between thromboses or bleeding. Interestingly patients with liver insufficiency may present with arterial or venous thrombotic episodes requiring antiplatelet and/or antithrombotic therapy despite low platelet count or prolonged INR. The aim of this review is to point on the current knowledge regarding hemostasis in patients with liver insufficiency underlining practical recommendations of the use of antiplatelet and anticoagulant drugs in this setting.
Keywords: Liver insufficiency, hemostasis rebalance, antiplatelets, antithrombotics.
Current Pharmaceutical Design
Title:Antiplatelets and Antithrombotics in Patients with Liver Insufficiency: From Pathophysiology to Clinical Practice
Volume: 23 Issue: 9
Author(s): Melanie Deutsch*John Koskinas
Affiliation:
- Dipartimento Cardio-toracovascolare, SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan 20162,Italy
Keywords: Liver insufficiency, hemostasis rebalance, antiplatelets, antithrombotics.
Abstract: The liver represents the site of synthesis of most procoagulant and anticoagulant factors, fibrinolytic proteins and thrombopoetin while being also involved in the clearance of hemostatic and fibrinolyic proteins. Therefore in patients with liver insufficiency a great variety of disturbances can be documented resulting however in a new “rebalanced” hemostatic system with a labile equilibrium between thromboses or bleeding. Interestingly patients with liver insufficiency may present with arterial or venous thrombotic episodes requiring antiplatelet and/or antithrombotic therapy despite low platelet count or prolonged INR. The aim of this review is to point on the current knowledge regarding hemostasis in patients with liver insufficiency underlining practical recommendations of the use of antiplatelet and anticoagulant drugs in this setting.
Export Options
About this article
Cite this article as:
Deutsch Melanie*, Koskinas John, Antiplatelets and Antithrombotics in Patients with Liver Insufficiency: From Pathophysiology to Clinical Practice, Current Pharmaceutical Design 2017; 23 (9) . https://dx.doi.org/10.2174/1381612822666161205113629
DOI https://dx.doi.org/10.2174/1381612822666161205113629 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Exploiting High-Throughput Ion Channel Screening Technologies in Integrated Drug Discovery
Current Pharmaceutical Design Augmentation of Creatine in the Heart
Mini-Reviews in Medicinal Chemistry FTIR Spectroscopy to Study Bioeffects of Static Magnetic Fields on Neuronal-like Cell Cultures
Current Metabolomics The Possible Involvement of HLA Class III Haplotype (RAGE, HSP70 and TNF Genes) in Alzheimer's Disease
Current Alzheimer Research Sildenafil for Antenatal Treatment of Congenital Diaphragmatic Hernia: From Bench to Bedside
Current Pharmaceutical Design Diabetic Cardiomyopathy and Oxidative Stress: Role of Antioxidants
Cardiovascular & Hematological Agents in Medicinal Chemistry Role of Sympathetic Nerve Activity in Obesity, Hypertension and Metabolic Syndrome
Current Hypertension Reviews Flaxseed for Health and Disease: Review of Clinical Trials
Combinatorial Chemistry & High Throughput Screening Association Between Anemia and Dementia: A Nationwide, Populationbased Cohort Study in Taiwan
Current Alzheimer Research Nitric Oxide and Disorders of the Erythrocyte: Emerging Roles and Therapeutic Targets
Cardiovascular & Hematological Disorders-Drug Targets Renal Cytochrome P450-Derived Eicosanoids and Hypertension
Current Hypertension Reviews Patent Selections
Recent Patents on Cardiovascular Drug Discovery Health Benefits of Honey: Implications for Treating Cardiovascular Diseases
Current Nutrition & Food Science Pathophysiology of Cardiovascular Diseases and the Role of Vitamins, and Herbal Extracts in the Reduction of Cardiovascular Risks
Cardiovascular & Hematological Agents in Medicinal Chemistry New Advances in Atrial Fibrillation Management: The Role of Apixaban
Current Drug Targets Management of Prehypertension: Current Status and Future Strategies
Current Hypertension Reviews Targeting Fibrosis in Systemic Sclerosis
Endocrine, Metabolic & Immune Disorders - Drug Targets Effect of Antipsychotic Drugs on Cerebrovascular Morbidity and Mortality: A Systematic Review
Current Drug Therapy Leptin and the Regulation of Renal Sodium Handling and Renal Na+- Transporting ATPases: Role in the Pathogenesis of Arterial Hypertension
Current Cardiology Reviews Cardiovascular Adverse Effects of Anti-Inflammatory Drugs
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry