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Procoagulant versus anticoagulant factors in cirrhotic patients

Mohamed A El Bokl1, Amal Shawky1, George S Riad1

  • 1Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology
|September 25, 2014
PubMed

Insights

Liver cirrhosis patients show an imbalance in clotting factors, with higher factor VIII and lower protein C, indicating a risk for bleeding or thrombosis. Low protein C function (PICI%) suggests hypercoagulability.

Area of Science:

  • Hepatology
  • Hematology
  • Coagulation Science

Background:

  • Liver cirrhosis impairs the production of most clotting factors.
  • Despite impaired clotting factor synthesis, cirrhotic patients are susceptible to thrombosis.
  • The study investigates procoagulant and anticoagulant factors in cirrhosis.

Purpose of the Study:

  • To assess procoagulant and anticoagulant factors in cirrhotic patients.
  • To correlate these factors with bleeding and/or thrombotic events.
  • To identify markers of hypercoagulability in liver cirrhosis.

Main Methods:

  • 102 subjects (51 cirrhotic, 51 controls) were enrolled.
  • Evaluated clotting factors (Factor VIII, Protein C), coagulation times (INR, PT, PTT), and platelet counts.
  • Assessed protein C system functionality using the Protac-induced coagulation inhibition percentage (PICI%) assay.

Main Results:

  • Cirrhotic patients had significantly higher Factor VIII and Factor VIII/Protein C ratios compared to controls.
  • Protein C levels and PICI% were significantly lower in cirrhotic patients.
  • These findings suggest an altered coagulation balance in liver cirrhosis.

Conclusions:

  • Cirrhotic patients exhibit an altered balance of coagulation factors, predisposing them to bleeding or thrombosis.
  • Low PICI% indicates impaired anticoagulant function of the protein C system.
  • A high Factor VIII/Protein C ratio and low PICI% may serve as indicators of hypercoagulability in liver cirrhosis.
Abstract

Keywords:
AnticoagulantsCirrhosisProcoagulants

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