A recent meta-analysis demonstrated that, when compaing the same age groups, the prevalence of AF in patients with LC is higher than the prevalence described in the general population (5–7% vs. 1.6%, p < 0.0001) in direct relation to LC severity, and higher mortality. Cirrhotic patients have been shown to have an increased risk of stroke compared with cirrhotic patients without AF (1.1% vs. The prevalence of AF in LC patients has been reported to be 11.6%, higher in decompensated LC and patients with alcoholic liver disease or non-alcoholic steatohepatitis (NASH), elderly, or associating comorbidities such as diabetes mellitus, arterial hypertension, chronic obstructive pulmonary disease, and chronic kidney disease. AF is one of the most common arrhythmias among patients with liver cirrhosis (LC). There has been an increasing prevalence of atrial fibrillation (AF) over the last few years with a negative impact on morbidity and mortality.
New bleeding and ischemic risk scores should be developed especially for patients with liver cirrhosis, and biomarkers for bleeding complications should be implemented in clinical practice to personalize this treatment in a very difficult population represented by decompensated liver cirrhosis patients. In Child–Pugh class C liver cirrhosis, direct oral anticoagulants are contraindicated. Direct oral anticoagulants are safer than warfarin in patients with compensated liver cirrhosis. This review aimed to evaluate the recent data regarding the safety and efficacy of anticoagulant treatment in patients with decompensated liver cirrhosis. Although patients with liver cirrhosis were excluded from the pivotal studies that confirmed the efficacy and safety of the anticoagulant treatment in patients with atrial fibrillation, data from real-life cohorts demonstrated that the anticoagulant treatment in patients with liver cirrhosis could be safe. Considering the impaired coagulation balance in liver cirrhosis, predisposing patients to bleed or thrombotic events, the anticoagulant treatment is still a matter of debate. Anticoagulant treatment is recommended for thromboembolic protection in patients with atrial fibrillation. Atrial fibrillation is frequently diagnosed in patients with liver cirrhosis, especially in those with non-alcoholic steatohepatitis or alcoholic etiology.
0 kommentar(er)
