The primary haemostasis is more preserved in thrombocytopenic patients with liver cirrhosis than cancer

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

In thrombocytopenia, differences in haemostatic capacity may explain discrepancies in bleeding risk between patients with cancer and patients with liver cirrhosis. The objective was to compare the haemostatic capacity in different thrombocytopenic patient populations. We evaluated platelet aggregation using impedance aggregometry (Multiplate Analyzer), von Willebrand factor antigen (VWF:Ag), VWF:ristocetin-cofactor activity (VWF:RCo), activated partial thromboplastin time (aPTT), coagulation factor VIII, fibrinogen, and thrombin generation in adult hospitalized patients with platelet count less than 80×10 9 /l. Patients either had liver cirrhosis (n=28), or cancer (n=169; n=49 had haematological cancer) with no difference among patients with liver cirrhosis and cancer. Median platelet count was 48×10 9 /l [interquartile range (IQR) 32-63×10 9 /l]. Median platelet aggregation was higher in patients with cirrhosis than cancer, 416 AU×min (IQR 257-676) versus 145 AU×min (IQR 50-326) for collagen-induced platelet aggregation, P<0.001. There was no difference in activated partial thromboplastin time (aPTT), coagulation factor VIII, or thrombin generation between the patient groups. Fibrinogen activity was higher in patients with cancer compared with patients with cirrhosis [12.5 μmol/L (IQR 9.9-16.5) versus 7.2μmol/l (IQR 5.6-10.2)], P<0.003. Patients with liver cirrhosis had a more preserved primary haemostasis compared with patients with cancer.

Original languageEnglish
JournalBlood Coagulation and Fibrinolysis
Volume29
Issue number3
Pages (from-to)307-313
ISSN0957-5235
DOIs
Publication statusPublished - Apr 2018

Fingerprint

Liver Neoplasms
Liver Cirrhosis
Platelet Aggregation
Neoplasms
Partial Thromboplastin Time
von Willebrand Factor
Hemostatics
Platelet Count
Electric Impedance

Keywords

  • Adult
  • Factor VIII/analysis
  • Female
  • Fibrinogen/metabolism
  • Hemostasis
  • Humans
  • Liver Cirrhosis/blood
  • Male
  • Middle Aged
  • Neoplasms/blood
  • Partial Thromboplastin Time
  • Platelet Aggregation
  • Platelet Count
  • Thrombin/biosynthesis
  • Thrombocytopenia/blood

Cite this

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title = "The primary haemostasis is more preserved in thrombocytopenic patients with liver cirrhosis than cancer",
abstract = "In thrombocytopenia, differences in haemostatic capacity may explain discrepancies in bleeding risk between patients with cancer and patients with liver cirrhosis. The objective was to compare the haemostatic capacity in different thrombocytopenic patient populations. We evaluated platelet aggregation using impedance aggregometry (Multiplate Analyzer), von Willebrand factor antigen (VWF:Ag), VWF:ristocetin-cofactor activity (VWF:RCo), activated partial thromboplastin time (aPTT), coagulation factor VIII, fibrinogen, and thrombin generation in adult hospitalized patients with platelet count less than 80×10 9 /l. Patients either had liver cirrhosis (n=28), or cancer (n=169; n=49 had haematological cancer) with no difference among patients with liver cirrhosis and cancer. Median platelet count was 48×10 9 /l [interquartile range (IQR) 32-63×10 9 /l]. Median platelet aggregation was higher in patients with cirrhosis than cancer, 416 AU×min (IQR 257-676) versus 145 AU×min (IQR 50-326) for collagen-induced platelet aggregation, P<0.001. There was no difference in activated partial thromboplastin time (aPTT), coagulation factor VIII, or thrombin generation between the patient groups. Fibrinogen activity was higher in patients with cancer compared with patients with cirrhosis [12.5 μmol/L (IQR 9.9-16.5) versus 7.2μmol/l (IQR 5.6-10.2)], P<0.003. Patients with liver cirrhosis had a more preserved primary haemostasis compared with patients with cancer.",
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author = "Vinholt, {Pernille Just} and Alnor, {Anne B} and Mads Nybo and Anne-Mette Hvas",
year = "2018",
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doi = "10.1097/MBC.0000000000000725",
language = "English",
volume = "29",
pages = "307--313",
journal = "Blood Coagulation and Fibrinolysis",
issn = "0957-5235",
publisher = "Lippincott Williams & Wilkins",
number = "3",

}

The primary haemostasis is more preserved in thrombocytopenic patients with liver cirrhosis than cancer. / Vinholt, Pernille Just; Alnor, Anne B; Nybo, Mads; Hvas, Anne-Mette.

In: Blood Coagulation and Fibrinolysis, Vol. 29, No. 3, 04.2018, p. 307-313.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - The primary haemostasis is more preserved in thrombocytopenic patients with liver cirrhosis than cancer

AU - Vinholt, Pernille Just

AU - Alnor, Anne B

AU - Nybo, Mads

AU - Hvas, Anne-Mette

PY - 2018/4

Y1 - 2018/4

N2 - In thrombocytopenia, differences in haemostatic capacity may explain discrepancies in bleeding risk between patients with cancer and patients with liver cirrhosis. The objective was to compare the haemostatic capacity in different thrombocytopenic patient populations. We evaluated platelet aggregation using impedance aggregometry (Multiplate Analyzer), von Willebrand factor antigen (VWF:Ag), VWF:ristocetin-cofactor activity (VWF:RCo), activated partial thromboplastin time (aPTT), coagulation factor VIII, fibrinogen, and thrombin generation in adult hospitalized patients with platelet count less than 80×10 9 /l. Patients either had liver cirrhosis (n=28), or cancer (n=169; n=49 had haematological cancer) with no difference among patients with liver cirrhosis and cancer. Median platelet count was 48×10 9 /l [interquartile range (IQR) 32-63×10 9 /l]. Median platelet aggregation was higher in patients with cirrhosis than cancer, 416 AU×min (IQR 257-676) versus 145 AU×min (IQR 50-326) for collagen-induced platelet aggregation, P<0.001. There was no difference in activated partial thromboplastin time (aPTT), coagulation factor VIII, or thrombin generation between the patient groups. Fibrinogen activity was higher in patients with cancer compared with patients with cirrhosis [12.5 μmol/L (IQR 9.9-16.5) versus 7.2μmol/l (IQR 5.6-10.2)], P<0.003. Patients with liver cirrhosis had a more preserved primary haemostasis compared with patients with cancer.

AB - In thrombocytopenia, differences in haemostatic capacity may explain discrepancies in bleeding risk between patients with cancer and patients with liver cirrhosis. The objective was to compare the haemostatic capacity in different thrombocytopenic patient populations. We evaluated platelet aggregation using impedance aggregometry (Multiplate Analyzer), von Willebrand factor antigen (VWF:Ag), VWF:ristocetin-cofactor activity (VWF:RCo), activated partial thromboplastin time (aPTT), coagulation factor VIII, fibrinogen, and thrombin generation in adult hospitalized patients with platelet count less than 80×10 9 /l. Patients either had liver cirrhosis (n=28), or cancer (n=169; n=49 had haematological cancer) with no difference among patients with liver cirrhosis and cancer. Median platelet count was 48×10 9 /l [interquartile range (IQR) 32-63×10 9 /l]. Median platelet aggregation was higher in patients with cirrhosis than cancer, 416 AU×min (IQR 257-676) versus 145 AU×min (IQR 50-326) for collagen-induced platelet aggregation, P<0.001. There was no difference in activated partial thromboplastin time (aPTT), coagulation factor VIII, or thrombin generation between the patient groups. Fibrinogen activity was higher in patients with cancer compared with patients with cirrhosis [12.5 μmol/L (IQR 9.9-16.5) versus 7.2μmol/l (IQR 5.6-10.2)], P<0.003. Patients with liver cirrhosis had a more preserved primary haemostasis compared with patients with cancer.

KW - Adult

KW - Factor VIII/analysis

KW - Female

KW - Fibrinogen/metabolism

KW - Hemostasis

KW - Humans

KW - Liver Cirrhosis/blood

KW - Male

KW - Middle Aged

KW - Neoplasms/blood

KW - Partial Thromboplastin Time

KW - Platelet Aggregation

KW - Platelet Count

KW - Thrombin/biosynthesis

KW - Thrombocytopenia/blood

U2 - 10.1097/MBC.0000000000000725

DO - 10.1097/MBC.0000000000000725

M3 - Journal article

VL - 29

SP - 307

EP - 313

JO - Blood Coagulation and Fibrinolysis

JF - Blood Coagulation and Fibrinolysis

SN - 0957-5235

IS - 3

ER -