Abstract
In the current issue of Digestive and Liver Disease, the meta-analysis by Koh and colleagues [1] addresses the efficacy and safety of direct oral anticoagulants (DOAC) versus vitamin K antagonist (VKA) for (non-malignant) portal vein thrombosis (PVT) in cirrhosis. It shows that DOAC attain higher rates of PVT recanalization and lower risk of PVT progression as compared to VKA, with similar risks of major bleeding, variceal bleeding, and death. This is a good news since DOAC overcome several disadvantages of VKA in patients with cirrhosis, mainly the confounding effect of an already prolonged INR and the inaccuracy of the INR scale, which do not qualify VKA as optimal anticoagulants in such patients.
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