Comparison of the efficacy and safety between rivaroxaban and dabigatran in the treatment of acute portal vein thrombosis in cirrhosis

作者全名："Zhou, Haonan; Wu, Mingdong; Yu, Shixiong; Xia, Han; Yu, Wu; Huang, Kai; Chen, Yikuan"

作者地址："[Zhou, Haonan; Wu, Mingdong; Yu, Wu; Huang, Kai; Chen, Yikuan] Chongqing Med Univ, Affiliated Hosp 2, Dept Vasc Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China; [Yu, Shixiong] Chongqing Med & Pharmaceut Coll, Affiliated Hosp 1, Dept Gen Surg, Chongqing 400060, Peoples R China; [Xia, Han] Army Med Univ, Clin Hosp 2, Dept Cardiothorac Surg, Chongqing 400000, Peoples R China"

通信作者："Chen, YK (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Vasc Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China."

来源：BMC GASTROENTEROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001071593600002

JCR分区：Q2

影响因子：2.5

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Acute portal vein thrombosis; Rivaroxaban; Dabigatran; Cirrhosis

摘要："BackgroundNew oral anticoagulants (NOACs) have been becoming prevalent in recent years and are increasingly used in the treatment of port vein thrombosis. The difference of the efficacy and safety between rivaroxaban and dabigatran remains unclear in the treatment of cirrhotic patients with acute portal vein thrombosis (PVT).MethodsThis retrospective study included all consecutive cirrhotic patients with acute portal vein thrombosis in our institute from January 2020 to December 2021. The patients received oral anticoagulation with rivaroxaban or dabigatran. The demographic, clinical, and imaging data of patients were collected. The diagnosis of acute PVT was confirmed by imaging examinations. The severity of liver cirrhosis was assessed using Child-Pugh score and Model for End-Stage Liver Disease (MELD) score. Outcomes included recanalization (complete, partial, and persistent occlusion), liver function, bleedings, and survival. The log-rank test was used to compare Kaplan-Meier distributions of time-to-event outcomes. The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).ResultsA total of 94 patients were included, 52 patients (55%) received rivaroxaban and 42 (45%) with dabigatran. The complete and partial recanalization of PVT was observed in 41 patients. There was no significant difference in complete recanalization, partial recanalization, and persistent occlusion between the two groups. With multivariate analysis, D-dimer (HR 1.165, 95% CI 1.036-1.311, p = 0.011) was independent predictors of complete recanalization. The Child-Pugh score (p = 0.001) was significantly improved in both two groups after anticoagulation, respectively. However, there was no difference between the two groups. The probability of survival was 94%, 95% in the rivaroxaban and dabigatran groups (log-rank p = 0.830). Major bleedings were reported in 3 patients (6%) in rivaroxaban group and 1 patient (2%) in dabigatran group (p = 0.646). Six patients (12%) in rivaroxaban group experienced minor bleeding, and five (12%) from dabigatran group (p = 0.691).ConclusionsThe efficacy and safety were comparable between rivaroxaban and dabigatran in the treatment of cirrhotic patients with acute portal vein thrombosis. And D-dimer can contribute to the prediction of PVT recanalization in cirrhotic patients."

基金机构：The work was supported by the Chongqing Science and Technology Foundation of China (No. CSTB2022NSCQ-MSX0805) and KuanRen Talents Program of the Second Affiliated Hospital of Chongqing Medical University (2019). [CSTB2022NSCQ-MSX0805]; Chongqing Science and Technology Foundation of China; KuanRen Talents Program of the Second Affiliated Hospital of Chongqing Medical University

基金资助正文：The work was supported by the Chongqing Science and Technology Foundation of China (No. CSTB2022NSCQ-MSX0805) and KuanRen Talents Program of the Second Affiliated Hospital of Chongqing Medical University (2019).