High levels of factor VIII and risk of extra-hepatic portal vein obstruction

Ida Martinelli, Massimo Primignani, Alessio Aghemo, Raffaella Reati, Paolo Bucciarelli, Federica Fabris, Tullia Battaglioli, Alessandra Dell'Era, Pier Mannuccio Mannucci

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background/Aims: High levels of coagulation factor VIII are a risk factor for lower-limb deep vein thrombosis (DVT). Their role in extra-hepatic portal vein obstruction (EHPVO) is not established. Methods: Factor VIII was measured in 85 patients with EHPVO (primary in 58 and complicating liver cirrhosis in 27), in 200 with lower-limb DVT, in 108 with liver cirrhosis without thrombosis and in 200 healthy controls. Results: Factor VIII levels were significantly higher in patients with primary EHPVO (138 IU/dL, range 86-366), EHPVO and cirrhosis (147 IU/dL, 95-242), lower-limb DVT (140 IU/dL, 64-400) and cirrhosis alone (160 IU/dL, 43-446) than in controls (112 IU/dL, 62-250, p <0.001). When factor VIII exceeded 129 IU/dL (66th percentile), the odds ratios were 10.5 (95%CI 3.3-33.4) for primary EHPVO, 6.0 (1.2-30.7) for EHPVO and cirrhosis, 5.0 (2.6-9.4) for lower-limb DVT. After exclusion of the effect of the acute phase reaction, the odds ratio for primary EHPVO was 4.2 (0.8-22.7), and was 8.7 (0.9-80.5) after exclusion also of patients with chronic myeloproliferative disorders. Conclusions: High factor VIII levels are independently associated with an increased risk for EHPVO. The risk of EHPVO increased with increasing factor VIII levels and was only partially dependent on the acute phase reaction.

Original languageEnglish
Pages (from-to)916-922
Number of pages7
JournalJournal of Hepatology
Volume50
Issue number5
DOIs
Publication statusPublished - May 2009

Fingerprint

Hepatic Veins
Factor VIII
Portal Vein
Venous Thrombosis
Lower Extremity
Acute-Phase Reaction
Fibrosis
Liver Cirrhosis
Odds Ratio
Myeloproliferative Disorders
Thrombosis

Keywords

  • Coagulation
  • Factor VIII
  • Liver disease
  • Portal vein thrombosis
  • Thrombophilia

ASJC Scopus subject areas

  • Hepatology

Cite this

High levels of factor VIII and risk of extra-hepatic portal vein obstruction. / Martinelli, Ida; Primignani, Massimo; Aghemo, Alessio; Reati, Raffaella; Bucciarelli, Paolo; Fabris, Federica; Battaglioli, Tullia; Dell'Era, Alessandra; Mannucci, Pier Mannuccio.

In: Journal of Hepatology, Vol. 50, No. 5, 05.2009, p. 916-922.

Research output: Contribution to journalArticle

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abstract = "Background/Aims: High levels of coagulation factor VIII are a risk factor for lower-limb deep vein thrombosis (DVT). Their role in extra-hepatic portal vein obstruction (EHPVO) is not established. Methods: Factor VIII was measured in 85 patients with EHPVO (primary in 58 and complicating liver cirrhosis in 27), in 200 with lower-limb DVT, in 108 with liver cirrhosis without thrombosis and in 200 healthy controls. Results: Factor VIII levels were significantly higher in patients with primary EHPVO (138 IU/dL, range 86-366), EHPVO and cirrhosis (147 IU/dL, 95-242), lower-limb DVT (140 IU/dL, 64-400) and cirrhosis alone (160 IU/dL, 43-446) than in controls (112 IU/dL, 62-250, p <0.001). When factor VIII exceeded 129 IU/dL (66th percentile), the odds ratios were 10.5 (95{\%}CI 3.3-33.4) for primary EHPVO, 6.0 (1.2-30.7) for EHPVO and cirrhosis, 5.0 (2.6-9.4) for lower-limb DVT. After exclusion of the effect of the acute phase reaction, the odds ratio for primary EHPVO was 4.2 (0.8-22.7), and was 8.7 (0.9-80.5) after exclusion also of patients with chronic myeloproliferative disorders. Conclusions: High factor VIII levels are independently associated with an increased risk for EHPVO. The risk of EHPVO increased with increasing factor VIII levels and was only partially dependent on the acute phase reaction.",
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T1 - High levels of factor VIII and risk of extra-hepatic portal vein obstruction

AU - Martinelli, Ida

AU - Primignani, Massimo

AU - Aghemo, Alessio

AU - Reati, Raffaella

AU - Bucciarelli, Paolo

AU - Fabris, Federica

AU - Battaglioli, Tullia

AU - Dell'Era, Alessandra

AU - Mannucci, Pier Mannuccio

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N2 - Background/Aims: High levels of coagulation factor VIII are a risk factor for lower-limb deep vein thrombosis (DVT). Their role in extra-hepatic portal vein obstruction (EHPVO) is not established. Methods: Factor VIII was measured in 85 patients with EHPVO (primary in 58 and complicating liver cirrhosis in 27), in 200 with lower-limb DVT, in 108 with liver cirrhosis without thrombosis and in 200 healthy controls. Results: Factor VIII levels were significantly higher in patients with primary EHPVO (138 IU/dL, range 86-366), EHPVO and cirrhosis (147 IU/dL, 95-242), lower-limb DVT (140 IU/dL, 64-400) and cirrhosis alone (160 IU/dL, 43-446) than in controls (112 IU/dL, 62-250, p <0.001). When factor VIII exceeded 129 IU/dL (66th percentile), the odds ratios were 10.5 (95%CI 3.3-33.4) for primary EHPVO, 6.0 (1.2-30.7) for EHPVO and cirrhosis, 5.0 (2.6-9.4) for lower-limb DVT. After exclusion of the effect of the acute phase reaction, the odds ratio for primary EHPVO was 4.2 (0.8-22.7), and was 8.7 (0.9-80.5) after exclusion also of patients with chronic myeloproliferative disorders. Conclusions: High factor VIII levels are independently associated with an increased risk for EHPVO. The risk of EHPVO increased with increasing factor VIII levels and was only partially dependent on the acute phase reaction.

AB - Background/Aims: High levels of coagulation factor VIII are a risk factor for lower-limb deep vein thrombosis (DVT). Their role in extra-hepatic portal vein obstruction (EHPVO) is not established. Methods: Factor VIII was measured in 85 patients with EHPVO (primary in 58 and complicating liver cirrhosis in 27), in 200 with lower-limb DVT, in 108 with liver cirrhosis without thrombosis and in 200 healthy controls. Results: Factor VIII levels were significantly higher in patients with primary EHPVO (138 IU/dL, range 86-366), EHPVO and cirrhosis (147 IU/dL, 95-242), lower-limb DVT (140 IU/dL, 64-400) and cirrhosis alone (160 IU/dL, 43-446) than in controls (112 IU/dL, 62-250, p <0.001). When factor VIII exceeded 129 IU/dL (66th percentile), the odds ratios were 10.5 (95%CI 3.3-33.4) for primary EHPVO, 6.0 (1.2-30.7) for EHPVO and cirrhosis, 5.0 (2.6-9.4) for lower-limb DVT. After exclusion of the effect of the acute phase reaction, the odds ratio for primary EHPVO was 4.2 (0.8-22.7), and was 8.7 (0.9-80.5) after exclusion also of patients with chronic myeloproliferative disorders. Conclusions: High factor VIII levels are independently associated with an increased risk for EHPVO. The risk of EHPVO increased with increasing factor VIII levels and was only partially dependent on the acute phase reaction.

KW - Coagulation

KW - Factor VIII

KW - Liver disease

KW - Portal vein thrombosis

KW - Thrombophilia

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