{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:54:32Z","timestamp":1789750472552,"version":"4.0.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2800,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:bold>Current guidelines recommend esophagogastroduodenoscopy (EGD) in patients with cirrhosis to screen for gastroesophageal varices (GEV). Thrombocytopenia has been proposed as a noninvasive test to predict the presence of GEV. There is no agreement regarding a specific platelet count (PLT) that can reliably predict GEV. The present longitudinal study aims to (1) further investigate the relationship between varices and PLT at the time of endoscopy, (2) investigate whether changes in PLT from the baseline over time can predict the development of GEV, and (3) investigate whether changes in PLT correlate with the hepatic venous pressure gradient (HVPG). A secondary analysis was conducted for 213 subjects with compensated cirrhosis with portal hypertension but without GEV enrolled in a randomized, placebo-controlled, double-blind trial of a nonselective beta-blocker used to prevent GEV. PLTs were obtained every 3 months, and HVPG measurements and EGD were done annually. The PLTs were compared between subjects who did and did not develop GEV. In a median follow-up of 54.9 months, 84 patients developed GEV. PLT was greater than 150,000 in 15% of patients at the development of GEV. A receiver operating curve did not show any PLT with high sensitivity or specificity for the presence of GEV. Subjects with clinically insignificant portal hypertension (HVPG &lt; 10 mm Hg) whose PLT remained greater than 100,000 had a 2-fold reduction in the occurrence of GEV (<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>= 0.0374). A significant correlation was found between HVPG and PLT at the baseline, year 1, and year 5 (<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>&lt; 0.0001).<\/jats:bold>\n                      <jats:bold>Conclusion:<\/jats:bold>\n                      <jats:bold>Cross-sectional or longitudinal evaluations of PLTs are inadequate noninvasive markers for GEV. Patients with mild portal hypertension whose PLT remains greater than 100,000 have significantly less risk of GEV. Although HVPG correlates somewhat with PLT, changes in PLT cannot be used as a surrogate for HVPG changes. (Hepatology 2008;47:153\u2013159.)<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.21941","type":"journal-article","created":{"date-parts":[[2007,12,27]],"date-time":"2007-12-27T10:50:42Z","timestamp":1198752642000},"page":"153-159","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":113,"title":["Platelet count is not a predictor of the presence or development of gastroesophageal varices in cirrhosis"],"prefix":"10.1097","volume":"47","author":[{"given":"Amir A.","family":"Qamar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman D.","family":"Grace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto J.","family":"Groszmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"Garcia-Tsao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew K.","family":"Burroughs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rie","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Planas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angels","family":"Escorsell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Garcia-Pagan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Patch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Matloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Makuch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-22-20241201","doi-asserted-by":"crossref","first-page":"A2","DOI":"10.1016\/S0016-5085(01)80011-1","article-title":"The incidence of esophageal varices in cirrhosis.","volume":"120","author":"DAmico","year":"2001","journal-title":"Gastroenterology"},{"key":"R2-22-20241201","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jhep.2005.05.009","article-title":"Evolving consensus in portal hypertension. Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension.","volume":"43","author":"De Franchis","year":"2005","journal-title":"J Hepatol"},{"key":"R3-22-20241201","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1053\/gast.2001.22580","article-title":"Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis.","volume":"120","author":"GarciaTsao","year":"2001","journal-title":"Gastroenterology"},{"key":"R4-22-20241201","first-page":"1081","article-title":"Diagnosis and treatment of gastrointestinal bleeding secondary to portal hypertension. American College of Gastroenterology Practice Parameters Committee.","volume":"92","author":"Grace","year":"1997","journal-title":"Am J Gastroenterol"},{"key":"R5-22-20241201","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1002\/hep.510280339","article-title":"Portal hypertension and variceal bleeding: an AASLD single topic symposium.","volume":"28","author":"Grace","year":"1998","journal-title":"HEPATOLOGY"},{"key":"R6-22-20241201","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.gie.2005.07.031","article-title":"ASGE guideline: the role of endoscopy in the management of variceal hemorrhage, updated July 2005.","volume":"62","author":"Qureshi","year":"2005","journal-title":"Gastrointest Endosc"},{"key":"R8-22-20241201","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1002\/hep.20018","article-title":"Noninvasive markers of esophageal varices: another round, not the last.","volume":"39","author":"DAmico","year":"2004","journal-title":"HEPATOLOGY"},{"key":"R9-22-20241201","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1056\/NEJMoa044456","article-title":", for the Portal Hypertension Collaborative Group. Betablockers to prevent gastroesophageal varices in patients with cirrhosis.","volume":"353","author":"Groszmann","year":"2005","journal-title":"N Engl J Med"},{"key":"R11-22-20241201","doi-asserted-by":"crossref","first-page":"2936","DOI":"10.1111\/j.1572-0241.2000.02325.x","article-title":"Prevalence of peripheral blood cytopenias (hypersplenism) in patients with nonalcoholic chronic liver disease.","volume":"95","author":"Bashour","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"R12-22-20241201","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/00042737-200104000-00004","article-title":"Hypersplenism.","volume":"13","author":"PeckRadosavljevic","year":"2001","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"Suppl D","key":"R13-22-20241201","first-page":"D60","article-title":"Thrombocytopenia in liver disease.","volume":"14","author":"PeckRadosavljevic","year":"2000","journal-title":"Can J Gastroenterol"},{"key":"R14-22-20241201","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/hep.20029","article-title":"Prevalence and predictors of esophageal varices in patients with primary sclerosing cholangitis.","volume":"39","author":"Zein","year":"2004","journal-title":"HEPATOLOGY"},{"key":"R15-22-20241201","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/S0168-8278(99)80288-8","article-title":"Noninvasive diagnosis of esophageal varices in chronic liver diseases.","volume":"31","author":"Pilette","year":"1999","journal-title":"J Hepatol"},{"key":"R16-22-20241201","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.1111\/j.1572-0241.1999.01540.x","article-title":"Factors predicting the presence of esophageal or gastric varices in patients with advanced liver disease.","volume":"94","author":"Zaman","year":"1999","journal-title":"Am J Gastroenterol"},{"key":"R17-22-20241201","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/00004836-200201000-00016","article-title":"Prediction of esophageal varices in patients with cirrhosis.","volume":"34","author":"Madhotra","year":"2002","journal-title":"J Clin Gastroenterol"},{"key":"R18-22-20241201","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/j.gie.2006.03.007","article-title":", and the HALTC Trial Group. The prevalence and risk factors associated with esophageal varices in subjects with hepatitis C and advanced fibrosis.","volume":"64","author":"Sanyal","year":"2006","journal-title":"Gastrointest Endosc"},{"key":"R19-22-20241201","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1002\/hep.20062","article-title":"The hepatic venous pressure gradient: anything worth doing should be done right.","volume":"39","author":"Groszmann","year":"2004","journal-title":"HEPATOLOGY"},{"key":"R20-22-20241201","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1111\/j.1572-0241.2001.03627.x","article-title":"The use of screening and preventive therapies for gastroesophageal varices in patients referred for evaluation of orthotopic liver transplantation.","volume":"96","author":"Arguedas","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"R21-22-20241201","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/j.1572-0241.2004.04145.x","article-title":"Changing compliance to the American College of Gastroenterology guidelines for the management of variceal hemorrhage: a regional survey.","volume":"99","author":"Zaman","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"R22-22-20241201","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1111\/j.1572-0241.2006.00874.x","article-title":"Platelet countspleen diameter ratio of esophageal varices: results of a multicenter, prospective, validation study.","volume":"101","author":"Giannini","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"R23-22-20241201","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1053\/j.gastro.2007.05.024","article-title":"Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis.","volume":"133","author":"Ripoll","year":"2007","journal-title":"Gastroenterology"},{"issue":"Suppl","key":"R24-22-20241201","first-page":"152","article-title":"Hepatic venous pressure gradient predicts the development of hepatocellular carcinoma independent of duration and severity of cirrhosis. Abstract.","volume":"44","author":"Ripoll","year":"2006","journal-title":"HEPATOLOGY"},{"key":"R25-22-20241201","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1590\/S0004-28032005000100009","article-title":"Correlation between platelet blood levels and the hepatic venous pressure gradient among patients with cirrhosis.","volume":"42","author":"Dittrich","year":"2005","journal-title":"Arq Gastroenterol"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.21941","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-200801000-00022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T08:23:06Z","timestamp":1733041386000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-200801000-00022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2008]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.21941","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1104716.560783","asserted-by":"object"}]},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2008,1]]}}}