Incidence and predictive factors of recurrent thrombosis in non-cirrhotic portal vein thrombosis. VALIDATION COHORT.

Sep 9, 2020

Background: Recurrent thrombosis (or rethrombosis, RT) is one of the main threats of chronic non-cirrhotic portal vein thrombosis (NC-PVT). Clinical guidelines only recommend long-term anticoagulation to prevent rethrombosis in patients with a recognized prothrombotic disorder or with a previous history of intestinal venous ischemia or thrombosis.

Project recruiting

Aims

To describe the rate of rethrombosis in NC-PVT and to identify its predictive factors.

Previous results: We included 114 patients with NC-PVT due to myeloproliferative neoplasm (n=29), thrombophilia disorders (n=12), exclusively local factors (n=36) or idiopathic PVT (n=37). According to current guidelines, patients with prothrombotic disorders were on long-term anticoagulation (except for those with specific contraindications) while most patients with idiopathic/local factor were not anticoagulated. Patients were followed-up with regular scheduled imaging studies, and RT was identified in 17 patients, with a cumulative probability of rethrombosis of 2.6%, 12.9% and 19.2% at 1, 5 and 10 years respectively. Most RT (82%) occurred in the subgroup of patients with idiopathic/local etiology not receiving long-term anticoagulation. In this subpopulation, factor V ≥90% and factor VIII≥150% were independently associated with RT.

VALIDATION COHORT: We aim at validating these results that suggest that patients with idiopathic or associated with chronic PVT not receiving long term anticoagulation that present high levels of Factor V and/or factor VIII are at higher risk of re-thrombosis.

Methods: enrollment of patients with idiopathic/local factor chronic PVT that have not received long-term anticoagulation in which the extension of the thrombosis has been thoroughly established at baseline and that have had a periodical imaging follow-up that ensured the detection of asymptomatic re-thrombosis during follow-up.

Regarding the determination of factor V and VIII, as they are not routinely included in most thrombophilia studies these patients will need to have a biobank plasma sample to do this analysis. The biobank sample should have been obtained not long after the chronic PVT diagnosis.

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