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Plasma Antithrombin III Levels Can Be a Prognostic Factor in Liver Cirrhosis Patients with Portal Vein Thrombosis.

Tsuyoshi SudaHajime TakatoriTakehiro HayashiKiichiro KajiKouki NioTakeshi TerashimaTetsuro ShimakamiKuniaki AraiTatsuya YamashitaEishiro MizukoshiMasao HondaKenichiro OkumuraKazuto KozakaTaro Yamashita
Published in: International journal of molecular sciences (2023)
Liver function influences the plasma antithrombin (AT)-III levels. AT-III is beneficial for patients with portal vein thrombosis (PVT) and low plasma AT-III levels. However, whether these levels affect prognosis in patients with cirrhosis-associated PVT remains unknown. This retrospective study involved 75 patients with cirrhosis and PVT treated with danaparoid sodium with or without AT-III. The plasma AT-III level was significantly lower in patients with liver failure-related death than in those with hepatocellular carcinoma (HCC)-related death ( p = 0.005), although the Child-Pugh and albumin-bilirubin (ALBI) scores were not significantly different between these two groups. Receiver operating characteristic curve analysis of the plasma AT-III levels showed cutoff values of 54.0% at 5-year survival. Low plasma AT-III levels (<54.0%) were associated with significantly worse prognosis than high levels in both overall survival ( p = 0.0013) and survival excluding HCC-related death ( p < 0.0001). Low plasma AT-III (<54.0%) was also associated with a significantly worse prognosis among patients with Child-Pugh A/B or ALBI grade 1/2 ( p < 0.0001). Multivariate analyses indicated that low plasma AT-III levels (<54.0%) were an independent prognostic factor for poor survival outcome. Low plasma AT-III levels may be associated with mortality, particularly liver failure-related death, independent of liver function.
Keyphrases
  • liver failure
  • prognostic factors
  • type diabetes
  • hepatitis b virus
  • risk factors
  • pulmonary embolism
  • free survival
  • coronary artery disease