PO56 | Safety of anticoagulant treatment in patients with splanchnic vein thrombosis and history of portal hypertension-related bleeding
R. Talerico1, S. Pellegrino1, A. Plessier2, F.R. Ponziani3, A. Porfidia1, F. Landi1, A. Gasbarrini3, R. Pola1, F. Santopaolo3 | 1Department of Geriatric, Orthopedic, and Rheumatologic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy; 2Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVE. Centre de recherche sur l’inflammation, Inserm, Paris, France; 3Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Background and Aims: Splanchnic vein thrombosis (SVT) can be associated to liver cirrhosis, or prothrombotic conditions, including myeloproliferative disorders, intra-abdominal inflammation, solid cancers, or surgery. While anticoagulation therapy improves outcomes in non-cirrhotic patients and reduces all-cause mortality in cirrhotic populations, its safety in patients with a history of portal hypertension (PH)-related bleeding is less clear. This systematic review examines the impact of anticoagulant therapy on re-bleeding risk in SVT patients with a history of PH-related bleeding.
Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. A comprehensive search of PubMed, Web of Science, and Scopus was performed for studies published up to September 2024. Studies were included if they compared SVT patients with a history of PH-related bleeding receiving anticoagulant therapy versus those not receiving anticoagulants. The primary outcome was the cumulative incidence of PH-related re-bleedings.
Results: Of 2,853 identified studies, five (186 participants) met the inclusion criteria: two randomized controlled trials (RCTs) and three observational studies. The cumulative incidence of PH-related re-bleeding was significantly lower in the anticoagulant group at 17.10% [95% CI 17.02, 17.19] compared to the control group at 40.00% [95% CI 39.90, 40.09]. The overall odds ratio (OR) from observational studies was 0.15 [95% CI 0.04, 0.52], indicating a reduced bleeding risk, while the OR from RCTs was 0.84 [95% CI 0.31, 2.32], showing a non-significant trend.
Conclusions: Anticoagulant therapy may reduce re-bleeding risk in SVT patients with a history of PH-related bleeding, but further high-quality studies are needed.
Altmetrics
Downloads
Citations
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
