Gastro Hep Advances (Jan 2024)

Hypoalbuminemia and Risk of Portal Vein Thrombosis in Cirrhosis

  • Roberto Cangemi,
  • Valeria Raparelli,
  • Giovanni Talerico,
  • Stefania Basili,
  • Francesco Violi,
  • Palasciano Giuseppe,
  • D’Alitto Felicia,
  • Palmieri Vincenzo Ostilio,
  • Santovito Daniela,
  • Di Michele Dario,
  • Croce Giuseppe,
  • Sacerdoti David,
  • Brocco Silvia,
  • Fasolato Silvano,
  • Cecchetto Lara,
  • Bombonato Giancarlo,
  • Bertoni Michele,
  • Restuccia Tea,
  • Andreozzi Paola,
  • Liguori Maria Livia,
  • Perticone Francesco,
  • Caroleo Benedetto,
  • Perticone Maria,
  • Staltari Orietta,
  • Manfredini Roberto,
  • De Giorgi Alfredo,
  • Averna Maurizio,
  • Giammanco Antonina,
  • Granito Alessandro,
  • Pettinari Irene,
  • Marinelli Sara,
  • Bolondi Luigi,
  • Falsetti Lorenzo,
  • Salvi Aldo,
  • Durante-Mangoni Emanuele,
  • Cesaro Flavio,
  • Farinaro Vincenza,
  • Ragone Enrico,
  • Morana Ignazio,
  • Andriulli Angelo,
  • Ippolito Antonio,
  • Iacobellis Angelo,
  • Niro Grazia,
  • Merla Antonio,
  • Raimondo Giovanni,
  • Maimone Sergio,
  • Cacciola Irene,
  • Varvara Doriana,
  • Drenaggi Davide,
  • Staffolani Silvia,
  • Picardi Antonio,
  • Vespasiani-Gentilucci Umberto,
  • Galati Giovanni,
  • Gallo Paolo,
  • Davì Giovanni,
  • Schiavone Cosima,
  • Santilli Francesca,
  • Tana Claudio,
  • Licata Anna,
  • Soresi Maurizio,
  • Bianchi Giovanni Battista,
  • Carderi Isabella,
  • Pinto Antonio,
  • Tuttolomondo Antonino,
  • Ferrari Giovanni,
  • Gresele Paolo,
  • Fierro Tiziana,
  • Morelli Olivia,
  • Laffi Giacomo,
  • Romanelli Roberto Giulio,
  • Arena Umberto,
  • Stasi Cristina,
  • Gasbarrini Antonio,
  • Gargovich Matteo,
  • Zocco Maria Assunta,
  • Riccardi Laura,
  • Ainora Maria Elena,
  • Capeci William,
  • Martino Giuseppe Pio,
  • Nobili Lorenzo,
  • Cavallo Maurizio,
  • Frugiuele Pierluigi,
  • Greco Antonio,
  • Pietrangelo Antonello,
  • Ventura Paolo,
  • Cuoghi Chiara,
  • Marcacci Matteo,
  • Serviddio Gaetano,
  • Vendemiale Gianluigi,
  • Villani Rosanna,
  • Gargano Ruggiero,
  • Vidili Gianpaolo,
  • Di Cesare Valentina,
  • Masala Maristella,
  • Delitala Giuseppe,
  • Invernizzi Pietro,
  • Di Minno Giovanni,
  • Tufano Antonella,
  • Purrello Francesco,
  • Privitera Graziella,
  • Forgione Alessandra,
  • Curigliano Valentina,
  • Senzolo Marco,
  • Rodríguez-Castro Kryssia Isabel,
  • Giannelli Gianluigi,
  • Serra Carla,
  • Neri Sergio,
  • Pignataro Pietro,
  • Rizzetto Mario,
  • Debernardi Venon Wilma,
  • Svegliati Baroni Gianluca,
  • Bergamaschi Gaetano,
  • Masotti Michela,
  • Costanzo Filippo,
  • Corazza Gino Roberto,
  • Caldwell Stephen Hugh,
  • Angelico Francesco,
  • Del Ben Maria,
  • Napoleone Laura,
  • Polimeni Licia,
  • Proietti Marco,
  • Raparelli Valeria,
  • Romiti Giulio Francesco,
  • Ruscio Eleonora,
  • Severoni Andrea,
  • Talerico Giovanni,
  • Toriello Filippo,
  • Vestri Annarita

Journal volume & issue
Vol. 3, no. 5
pp. 646 – 653

Abstract

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Background and Aims: Hypoalbuminemia, as defined by serum albumin (SA) levels ≤35 g/L, is associated to venous and arterial thrombosis in general population and in patients at risk of cardiovascular disease. It is unknown if SA ≤35 g/L is also associated to portal vein thrombosis (PVT) in cirrhosis. Methods: Cirrhotic patients enrolled in the Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry (PRO-LIVER) study (n = 753), were followed-up for 2 years to assess the risk of PVT, that was diagnosed by Doppler ultrasonography. Child-Pugh classes, Model for End-Stage Liver Disease score, presence of hepatocellular carcinoma and laboratory variables including SA, D-dimer, and high-sensitivity C-reactive protein (hs-CRP) were measured at baseline. Results: SA ≤35 g/L was detected in 52% of patients. A logistic multivariate regression analysis showed that higher Child-Pugh class, hepatocellular carcinoma and thrombocytopenia were significantly associated to SA ≤35 g/L. In a subgroup of patients where data regarding hs-CRP and D-dimer were available, SA ≤35 g/L was inversely associated with hs-CRP and D-dimer. During the follow-up, a total of 61 patients experienced PVT. A Kaplan Meier survival analysis showed SA ≤35 g/L was associated to increased risk of PVT compared to SA >35 g/L (P = .005). A multivariate Cox proportional hazards regression analysis showed that male sex, lower platelet count, and SA ≤35 g/L remained associated to PVT after adjusting for confounding factors. Conclusion: Cirrhotic patients with SA ≤35 g/L are at higher risk of experiencing PVT compared to those with SA >35 g/L and could be considered as potential candidates to anticoagulant prophylaxis for PVT prevention.

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