ArticlePloS one2017
Decreased prothrombin conversion and reduced thrombin inactivation explain rebalanced thrombin generation in liver cirrhosis.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 39 citations in OpenAlex.
- Prothrombin conversion accelerates with increasing age in women but not in men: findings from the Moli-sani Cohort Study.Research and practice in thrombosis and haemostasis · 2026Article
- Thrombin dynamics and clinical events in cirrhosis: low prothrombin conversion predicts bleeding risk.Frontiers in cell and developmental biology · 2026Article
- Association between international normalized ratio-to-albumin ratio and mortality in critically ill patients with gastrointestinal bleeding: a retrospective MIMIC-IV database study.BMC gastroenterology · 2025Article
- Ocular Surface Allostasis-When Homeostasis Is Lost: Challenging Coping Potential, Stress Tolerance, and Resilience.Biomolecules · 2023Review
- Portal Vein Recanalization-Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) Facilitates Liver Transplantation in Cirrhotic Patients with Occlusive Portal Vein Thrombosis.Seminars in interventional radiology · 2023Review
- Abacavir use is associated with increased prothrombin conversion.Frontiers in immunology · 2023Article
- Low antithrombin levels are associated with low risk of cardiovascular death but are a risk factor for cancer mortality.PloS one · 2022Article
- Semi-automated thrombin dynamics applying the ST Genesia thrombin generation assay.Frontiers in cardiovascular medicine · 2022Article
- Functional changes in hemostasis during asexual and sexual parasitemia in a controlled human malaria infection.PloS one · 2022Article
- Portal Vein Thrombosis In Cirrhosis: Interventional Treatment Options.Current gastroenterology reports · 2021Review
- Thrombin Generation in Chronic Liver Diseases-A Pilot Study.Healthcare (Basel, Switzerland) · 2021Article
- ST Genesia reference values of 117 healthy donors measured with STG-BleedScreen, STG-DrugScreen and STG-ThromboScreen reagents.Research and practice in thrombosis and haemostasis · 2021Article
- Deciphering the coagulation profile through the dynamics of thrombin activity.Scientific reports · 2020Article
- Pentraxin-3 is not related to disease severity in cirrhosis and hepatocellular carcinoma patients.Clinical and experimental medicine · 2020Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Impaired coagulation factor synthesis in cirrhosis causes a reduction of most pro- and anticoagulant factors. Cirrhosis patients show no clear bleeding or thrombotic phenotype, although they are at risk for both types of hemostatic event. Thrombin generation (TG) is a global coagulation test and its outcome depends on underlying pro- and anticoagulant processes (prothrombin conversion and thrombin inactivation). We quantified the prothrombin conversion and thrombin inactivation during TG in 30 healthy subjects and 52 Child-Pugh (CP-) A, 15 CP-B and 6 CP-C cirrhosis patients to test the hypothesis that coagulation is rebalanced in liver cirrhosis patients. Both prothrombin conversion and thrombin inactivation are reduced in cirrhosis patients. The effect on pro- and anticoagulant processes partially cancel each other out and as a result TG is comparable at 5 pM tissue factor between healthy subjects and patients. This supports the hypothesis of rebalanced hemostasis, as TG in cirrhosis patients remains within the normal range, despite large changes in prothrombin conversion and thrombin inactivation. Nevertheless, in silico analysis shows that normalization of either prothrombin conversion or thrombin inactivation to physiological levels, by for example the administration of prothrombin complex concentrates would cause an elevation of TG, whereas the normalization of both simultaneously maintains a balanced TG. Therefore, cirrhosis patients might require adapted hemostatic treatment.
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