Thrombin Generation in Chronic Liver Diseases—A Pilot Study

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.

Proteomics identifies complement protein signatures in patients with alcohol-associated hepatitis

“…Notably, F2 emerged as a significant predictor (P < 0.0001) of mortality in these patients. This is consistent with prior research indicating reduced thrombin production in chronic liver disease, worsening with disease progression (53). Moreover, studies have associated coagulation abnormalities with increased morbidity and mortality in chronic liver disease (54).…”

Portal vein thrombosis in liver cirrhosis: An updated overview

“…Subsequently, the potential for thrombin generation is normal or increased in patients with liver cirrhosis. Antithrombin III (AT‐III) deficiency also indirectly leads to increased thrombin 38 ; however, a decrease in thrombin generation followed by liver disease progression can also occur 39 . For fibrinolysis markers, it suggested that D‐dimer may be a predictive indicator for PVT development in cirrhotic patients; however, it lacks the capability of distinguishing between PVT and liver dysfunction 40 …”