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
-
Development of Radiolabeled Compounds for Myocardial Perfusion Imaging
Current Pharmaceutical Design Optimizing the Management of Uncontrolled/Resistant Hypertension. The Importance of Sleep Apnoea Syndrome
Current Vascular Pharmacology Systemic Sclerosis-Associated Interstitial Lung Disease: Lessons from Clinical Trials, Outcome Measures, and Future Study Design
Current Rheumatology Reviews Therapeutic Applications of Liposomal Based Drug Delivery and Drug Targeting for Immune Linked Inflammatory Maladies: A Contemporary View Point
Current Drug Targets Adenosine and ATP Receptors in the Brain
Current Topics in Medicinal Chemistry Preeclampsia: Placental Origins, New Predictors and New Therapeutic Strategies
Current Women`s Health Reviews The Clinical Problems of Hypertension Treatment in Hemodialysis Patients
Current Vascular Pharmacology Editorial [Hot Topic:Stabilizing the Vulnerable Plaque: The Search for the Magic Bullet (Executive Editors: G. Pasterkamp and M. Daemen)]
Current Pharmaceutical Design Proinflammatory Activities of Leptin in Non-Autoimmune Conditions
Inflammation & Allergy - Drug Targets (Discontinued) Drug Therapies in the Secondary Prevention of Cardiovascular Diseases:Successes, Shortcomings and Future Directions
Current Vascular Pharmacology Vitamin D and the Metabolic Syndrome
Current Vascular Pharmacology Relationship Between Inflammation, Insulin Resistance and Type 2 Diabetes: Cause or Effect?
Current Diabetes Reviews Fetal Mechanisms That Lead to Later Hypertension
Current Drug Targets Fermented Foods: Patented Approaches and Formulations for Nutritional Supplementation and Health Promotion
Recent Patents on Food, Nutrition & Agriculture Obstructive Sleep Apnea Syndrome: Implications in Cardiovascular Disease
Current Respiratory Medicine Reviews Nifedipine Inhibits the Progression of An Experimentally Induced Cerebral Aneurysm in Rats with Associated Down-Regulation of NF-Kappa B Transcriptional Activity
Current Neurovascular Research Vascular Dysfunction in the Brain; Implications for Heavy Metal Exposures
Current Hypertension Reviews Platelet Oxidative Stress and its Relationship with Cardiovascular Diseases in Type 2 Diabetes Mellitus Patients
Current Medicinal Chemistry Increased Arterial Stiffness is Associated with Poor Collaterals in Acute Ischemic Stroke from Large Vessel Occlusion
Current Neurovascular Research Editorial (Thematic Issue: Idiopathic Pulmonary Fibrosis)
Clinical Anti-Inflammatory & Anti-Allergy Drugs (Discontinued)