SynthesisJournal of hepatology2023
Anticoagulation improves survival in patients with cirrhosis and portal vein thrombosis: The IMPORTAL competing-risk meta-analysis.
Synthesis in Journal of hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07571460 (Dose Prediction for Statins and Anticoagulant Medications in Cirrhotic Patients Using Simcyp Program), which is not on this map. Cited by 57 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Dose Prediction for Statins and Anticoagulant Medications in Cirrhotic Patients Using Simcyp Program: Applications in Clinical Practice
Who cites it
57 citing papers in PubMed, 3 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Direct oral anticoagulants in portal vein thrombosis in patients with cirrhosis: a systematic review and meta-analysis.Blood advances · 2026Pooled it
- Safety of Anticoagulant Treatment in Patients With Splanchnic Vein Thrombosis and History of Portal Hypertension-Related Bleeding.Liver international : official journal of the International Association for the Study of the Liver · 2025Pooled it
- Comparative Effectiveness and Safety of Various Anticoagulation Regimens for Portal Venous Thrombosis in Cirrhosis: A Systematic Review and Network Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Managing Coagulation Abnormalities, Bleeding, and Thrombosis in Patients with Cirrhosis.Journal of general internal medicine · 2026Review
- Endoscopic ultrasound-guided portal venous thrombolysis: A promising avenue.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- [Novel targets and drugs for the treatment of portal hypertension in liver cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Visualization of intrahepatic activation of coagulation and its contribution to disease progression in mice with acetaminophen-induced acute liver injury.Journal of thrombosis and haemostasis : JTH · 2026Article
- Endothelial-to-mesenchymal transition: A targetable mechanism that contributes to portal vein thrombosis in cirrhosis.Hepatology (Baltimore, Md.) · 2026Article
- Bleeding and Thrombotic Risk in Cirrhosis: Hemostatic Profiles from a Single-Center Experience.Life (Basel, Switzerland) · 2026Article
- Article
- The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus.Hepatology communications · 2026Article
- Navigating the Hemostatic Balance: Anticoagulation and Antiplatelet Therapy in Patients with Thrombocytopenia.Journal of clinical medicine · 2026Review
- Association of Early Heparin Use with Mortality in Cirrhotic Patients: A Retrospective Cohort Study.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- Balancing Thrombosis and Bleeding: Antithrombotic Therapy in Cirrhosis-Related Thrombocytopenia.Journal of clinical medicine · 2026Review
- Coagulation Abnormalities in Liver Cirrhosis: Diagnostic and Therapeutic Approaches.Medicina (Kaunas, Lithuania) · 2026Review
- Clinical and pathophysiological perspectives on haemostasis, inflammation, and thrombo-haemorrhagic risk in cirrhosis.EXCLI journal · 2026Review
- Preoperative Portal Vein Thrombosis Grading Predicts Post-Transplant Thrombosis and Survival.Therapeutics and clinical risk management · 2026Article
- Continuous versus intermittent anticoagulation during endoscopic treatment of esophageal varices in cirrhosis: a randomized controlled trial.Therapeutic advances in gastroenterology · 2026Article
- A Retrospective Analysis of 581 Cases of Esophagogastric Variceal Bleeding Complicated by Portal Vein Thrombosis at a Single Center.Canadian journal of gastroenterology & hepatology · 2026Article
- Diagnosis and Management of Portal Vein Thrombosis in Patients With Cirrhosis.Gastroenterology & hepatology · 2025Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
13 authors at 7 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsPrevious meta-analyses demonstrated the safety and efficacy of anticoagulation in the recanalization of portal vein thrombosis in patients with cirrhosis. Whether this benefit translates into improved survival is unknown. We conducted an individual patient data (IPD) meta-analysis to assess the effect of anticoagulation on all-cause mortality in patients with cirrhosis and portal vein thrombosis.
methodsIn this IPD meta-analysis, we selected studies comparing anticoagulation vs. no treatment in patients with cirrhosis and portal vein thrombosis from PubMed, Embase, and Cochrane databases (until June 2020) (PROSPERO no.: CRD42020140026). IPD were subsequently requested from authors. The primary outcome - the effect of anticoagulation on all-cause mortality - was assessed by a one-step meta-analysis based on a competing-risk model with liver transplantation as the competing event. The model was adjusted for clinically relevant confounders. A multilevel mixed-effects logistic regression model was used to determine the effect of anticoagulation on recanalization.
resultsIndividual data on 500 patients from five studies were included; 205 (41%) received anticoagulation and 295 did not. Anticoagulation reduced all-cause mortality (adjusted subdistribution hazard ratio 0.59; 95% CI 0.49-0.70), independently of thrombosis severity and recanalization. The effect of anticoagulation on all-cause mortality was consistent with a reduction in liver-related mortality. The recanalization rate was higher in the anticoagulation arm (adjusted odds ratio 3.45; 95% CI 2.22-5.36). The non-portal-hypertension-related bleeding rate was significantly greater in the anticoagulation group.
conclusionsAnticoagulation reduces all-cause mortality in patients with cirrhosis and portal vein thrombosis independently of recanalization, but at the expense of increasing non-portal hypertension-related bleeding. PROSPERO REGISTRATION NUMBER: CRD42020140026. IMPACT AND IMPLICATIONS: Anticoagulation is effective in promoting recanalization of portal vein thrombosis in patients with cirrhosis, but whether this benefit translates into improved survival is controversial. Our individual patient data meta-analysis based on a competing-risk model with liver transplantation as the competing event shows that anticoagulation reduces all-cause mortality in patients with cirrhosis and portal vein thrombosis independently of recanalization. According to our findings, portal vein thrombosis may identify a group of patients with cirrhosis that benefit from long-term anticoagulation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.