Liver status and outcomes in patients without previous known liver disease receiving anticoagulant therapy for venous thromboembolism

• DOI: 10.1007/s11739-021-02858-x
• Publication Date: 2021-10-10T16:15:06Z
• Authors: Diego Martínez-Ur...; Rocío G. de la Garza; Paula Villares-Fe...; Carme Font; Sebastian Schellong; Juan José López-N...; Aída Gil-Díaz; María del Carmen ...; Jana Hirmerova; Manuel Monreal; ; MD Adarraga; J Aibar; J Alonso; C Amado; JI Arcelus; A Asuero; A Ballaz; R Barba; C Barbagelata; M Barrón; B Barrón-Andrés; A Blanco-Molina; F Beddar Chaib; E Botella; J Castro; L Chasco; J Criado; C de Ancos; J del Toro; P Demelo-Rodríguez; AM Díaz-Brasero; MC Díaz-Pedroche; JA Díaz-Peromingo; MV Di Campli; A Dubois-Silva; JC Escribano; F Espósito; AI Farfán-Sedano; C Fernández-Capitán; JL Fernández-Reyes; MA Fidalgo; K Flores; C Font; L Font; I Francisco; C Gabara; F Galeano-Valle; MA García; F García-Bragado; M García de Herreros; RG de la Garza; C García-Díaz; A Gil-Díaz; C Gómez-Cuervo; E Grau; L Guirado; J Gutiérrez; L Hernández-Blasco; L Jara-Palomares; MJ Jaras; D Jiménez; R Jiménez; C Jiménez-Alfaro; MD Joya; S Lainez-Justo; A Lalueza; A Latorre; J Lima; JL Lobo; L López-Jiménez; P López-Miguel; JJ López-Núñez; R López-Reyes; JB López-Sáez; A Lorenzo; O Madridano; A Maestre; PJ Marchena; M Martín del Pozo; F Martín-Martos; D Martínez-Urbist...; C Mella; MI Mercado; J Moisés; M Monreal; A Muñoz-Blanco; JA Nieto; E Nofuentes-Pérez; MJ Núñez-Fernández; M Olid-Velilla; MC Olivares; J Osorio; S Otalora; R Otero; D Paredes; JM Pedrajas; JA Porras; J Portillo; I Redondo; C Rodríguez-Matute; V Rosa; P Ruiz-Artacho; J Ruiz-Ruiz; G Salgueiro; R Sánchez-Martínez; JF Sánchez-Muñoz-...; T Sancho; S Soler; B Suárez-Rodríguez; JM Suriñach; MI Torres; A Torres-Sánchez; C Tolosa; J Trujillo-Santos; F Uresandi; B Valero; R Valle; JF Varona; L Vela; JR Vela; G Vidal; A Villalobos; P Villares; C Zamora; C Ay; S Nopp; I Pabinger; MM Engelen; T Vanassche; P Verhamme; J Hirmerova; R Malý; S Accassat; N Ait Abdallah; L Bertoletti; A Bura-Riviere; J Catella; F Couturaud; B Crichi; P Debourdeau; O Espitia; D Farge-Bancel; C Grange; H Helfer; K Lacut; R Le Mao; I Mahé; P Morange; F Moustafa; G Poenou; G Sarlon-Bartoli; P Suchon; I Quere; S Schellong; A Braester; B Brenner; G Kenet; I Tzoran; M Basaglia; F Bilora; C Bortoluzzi; B Brandolin; M Ciammaichella; A De Angelis; P Di Micco; E Imbalzano; S Merla; R Pesavento; P Prandoni; C Siniscalchi; A Tufano; A Visonà; N Vo Hong; B Zalunardo; Y Nishimoto; Y Sato; K Make; A Skride; S Strautmane; S Fonseca; F Martins; J Meireles; M Bosevski; H Bounameaux; L Mazzolai; JA Caprini; HM Bui
• Keywords: 0303 health sciences; VTE risk assessment; Liver Diseases; Anticoagulation adverse events; Clinical VTE; Healthy individuals; Non-invasive liver assessment; VTE risk assessment; Anticoagulants; Hemorrhage; Venous Thromboembolism; Im - Original; 3. Good health; Non-invasive liver assessment; Healthy individuals; 03 medical and health sciences; Recurrence; Anticoagulation adverse events; Humans; Registries; Clinical VTE; 32 Ciencias médicas; 3205 Medicina interna

The association between elevated liver enzymes or FIB-4 (fibrosis index 4) and outcome in patients with venous thromboembolism (VTE) has not been evaluated. Data from patients in RIETE (Registro Informatizado Enfermedad TromboEmbólica) were used to assess the association between elevated liver enzymes or FIB-4 levels and the rates of major bleeding or death in apparent liver disease-free patients with acute VTE under anticoagulation therapy. A total of 6206 patients with acute VTE and without liver disease were included. Of them, 92 patients had major bleeding and 168 died under anticoagulation therapy. On multivariable analysis, patients with elevated liver enzymes were at increased mortality risk (HR: 1.58; 95% CI: 1.10-2.28), while those with FIB-4 levels > 2.67 points were at increased risk for major bleeding (HR: 1.69; 95% CI: 1.04-2.74). Evaluation of liver enzymes and FIB-4 index at baseline in liver disease-free patients with VTE may provide additional information on the risk for major bleeding or death during anticoagulation.