Antiplatelets and Antithrombotics in Patients with Liver Insufficiency: From Pathophysiology to Clinical Practice

Title:Antiplatelets and Antithrombotics in Patients with Liver Insufficiency: From Pathophysiology to Clinical Practice

Volume: 23 Issue: 9

Author(s): Melanie Deutsch*John Koskinas

Affiliation:

• Dipartimento Cardio-toracovascolare, SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan 20162,Italy

Keywords: Liver insufficiency, hemostasis rebalance, antiplatelets, antithrombotics.

Abstract: The liver represents the site of synthesis of most procoagulant and anticoagulant factors, fibrinolytic proteins and thrombopoetin while being also involved in the clearance of hemostatic and fibrinolyic proteins. Therefore in patients with liver insufficiency a great variety of disturbances can be documented resulting however in a new “rebalanced” hemostatic system with a labile equilibrium between thromboses or bleeding. Interestingly patients with liver insufficiency may present with arterial or venous thrombotic episodes requiring antiplatelet and/or antithrombotic therapy despite low platelet count or prolonged INR. The aim of this review is to point on the current knowledge regarding hemostasis in patients with liver insufficiency underlining practical recommendations of the use of antiplatelet and anticoagulant drugs in this setting.

Cite this article as:

Deutsch Melanie*, Koskinas John, Antiplatelets and Antithrombotics in Patients with Liver Insufficiency: From Pathophysiology to Clinical Practice, Current Pharmaceutical Design 2017; 23 (9) . https://dx.doi.org/10.2174/1381612822666161205113629