Evaluation of Low-Molecular-Weight Heparin for Treatment of Portal Vein Thrombosis in Liver Cirrhosis Patients
- 주제(키워드) portal vein thrombosis , dalteparin , low-molecular-weight heparin , liver cirrhosis
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Han, Ji Min] Chungbuk Natl Univ, Coll Pharm, Cheongju 28160, South Korea; [Han, Ji Min; Kim, Sung Hwan; Suh, Sung Yun; Cho, Yoon Sook] Seoul Natl Univ Hosp, Dept Pharm, Seoul 03080, South Korea; [Koh, Youngil; Lee, Jeong-Hoon; Yu, Su Jong; Yoon, Jung-Hwan] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul 03080, South Korea; [Koh, Youngil] Seoul Natl Univ, Canc Res Inst, Coll Med, Seoul 03080, South Korea; [Lee, Jeong-Hoon; Yu, Su Jong; Yoon, Jung-Hwan] Seoul Natl Univ, Liver Res Inst, Coll Med, Seoul 03080, South Korea; [Gwak, Hye Sun] Ewha Womans Univ, Coll Pharm, Seoul 03760, South Korea; [Gwak, Hye Sun] Ewha Womans Univ, Grad Sch Pharmaceut Sci, Seoul 03760, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 MDPI
- 발행년도 2023
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000204254
- 본문언어 영어
- Published As https://doi.org/10.3390/medicina59020292
초록/요약
Background and Objectives: Even though low-molecular-weight heparin (LMWH), including dalteparin, has a critical role in portal vein thrombosis (PVT) treatment in liver cirrhosis (LC) patients, the predictive factors and the proper dose of dalteparin for PVT treatment and relapse have not yet been investigated. Materials and Methods: This retrospective study evaluated the records of LC patients receiving dalteparin from July 2013 to June 2019. The odds ratio (OR) and adjusted OR were calculated from univariate and multivariable analyses, respectively. Results: Among data from 121 patients, the overall recanalization rate of all patients was 66.1% (80 patients). No history of variceal bleeding (OR 4.6, 95% CI: 1.88-11.43) and the case of newly developed thrombus before dalteparin treatment (OR 3.2, 95% CI: 1.24-8.08) were predictive factors associated with increased treatment response. Relapse of PVT occurred in 32 out of 80 patients (40%) who showed a recanalization. The risk of relapse was 3.1-3.9 times higher in those who took more than three months or more than six months from the diagnosis of PVT to dalteparin treatment compared to those who took less than these durations, respectively. In the dosing regimen, patients with the kg-based dosing regimen showed 2.6 times better response than those with the fixed dosing regimen. However, no difference in bleeding complications was observed. Conclusion: In the dosing regimen, the kg-based regimen that was the same as the venous thromboembolism regimen was a better option for the efficacy and safety of dalteparin therapy. Additionally, when treating PVT in LC patients, careful monitoring is recommended for patients with predictive factors for treatment response and relapse of PVT.
more