Abstract
The knowledge about coagulation disorders in patients with chronic liver disease changed in the last decade. The aim of this study was to analyze the parameters of thrombin generation in patients with chronic liver disease, as they are the most appropriate biomarkers to explore coagulation. (1) Background: The knowledge about coagulation disorders in patients with chronic liver disease changed in the last decade. The study of thrombin generation in patients with chronic liver disease provides a much more accurate assessment of the coagulation cascade; (2) Methods: This study is a prospective observational pilot study on hospitalized patients with chronic liver diseases that analyzed thrombin generation performed from their platelet-poor plasma versus that of control subjects. We analyzed a group of 59 patients with chronic liver disease and 62 control subjects; (3) Results: Thrombin generation was lower in hepatitis and cirrhosis patients compared to controls and decreases as the disease progressed. Lag time was higher in ethanolic etiology compared to the control group. Peak thrombin and endogenous thrombin potential were shorter in all etiologies when compared to the control group. The velocity index was significantly lower in HCV hepatopathies, ethanolic, and mixed etiology when compared with normal individuals; (4) Conclusions: Given the variability of thrombin generation in patients with chronic liver disease, its assay could serve to identify patients with high thrombotic and hemorrhagic risk and establish personalized conduct toward them.
Highlights
Excessive alcohol consumption, obesity, and viral hepatitis infections are the major etiological factors of chronic liver disease, which is a public health issue around the world [1]
We analyzed a group of 59 patients with chronic liver disease and 62 control subjects; (3) Results: Thrombin generation was lower in hepatitis and cirrhosis patients compared to controls and decreases as the disease progressed
The velocity index was significantly lower in HCV hepatopathies, ethanolic, and mixed etiology when compared with normal individuals; (4) Conclusions: Given the variability of thrombin generation in patients with chronic liver disease, its assay could serve to identify patients with high thrombotic and hemorrhagic risk and establish personalized conduct toward them
Summary
Obesity (including that of children and young people), and viral hepatitis infections are the major etiological factors of chronic liver disease, which is a public health issue around the world [1]. The availability of new and effective treatment options for viral hepatitis [2] and the increasing prevalence of obesity lead, over time, to the change in the proportion of the main etiologies of chronic liver disease. Nonalcoholic fatty liver disease, which is the liver manifestation of metabolic syndrome, is already the main cause of chronic liver disease worldwide [3] and of cirrhosis considered to be cryptogenic [2]. The prevalence of nonalcoholic fatty liver disease is increasing in Europe, too, as a result of higher obesity rates in most European countries [1]
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