{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:35:05Z","timestamp":1792611305784,"version":"4.5.0"},"reference-count":30,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Carlos III Health Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["JR20\/0024"],"award-info":[{"award-number":["JR20\/0024"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["JR20\/00047"],"award-info":[{"award-number":["JR20\/00047"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["CM19\/00024"],"award-info":[{"award-number":["CM19\/00024"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["PI21\/01995"],"award-info":[{"award-number":["PI21\/01995"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["CIBEREHD CB06 04 0026"],"award-info":[{"award-number":["CIBEREHD CB06 04 0026"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal-of-hepatology.eu","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hepatology"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.jhep.2025.06.035","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T22:21:57Z","timestamp":1752963717000},"page":"1069-1076","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":16,"title":["Rivaroxaban to prevent complications of portal hypertension in cirrhosis: The CIRROXABAN study"],"prefix":"10.1016","volume":"83","author":[{"given":"\u00c1ngela","family":"Puente","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Tur\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0094-7291","authenticated-orcid":false,"given":"Javier","family":"Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5255-9445","authenticated-orcid":false,"given":"Jose Ignacio","family":"Fortea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Hern\u00e1ndez","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edilmar","family":"Alvarado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Pons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Magaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6612-7501","authenticated-orcid":false,"given":"Elba","family":"Llop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9496-2133","authenticated-orcid":false,"given":"Carmen","family":"Alvarez-Navascu\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Amador","family":"Navarrete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9246-4264","authenticated-orcid":false,"given":"Marina","family":"Berenguer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0632-1393","authenticated-orcid":false,"given":"Helena","family":"Masnou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-8437","authenticated-orcid":false,"given":"Rafael","family":"Ba\u00f1ares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Casado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Ampuero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0716-8784","authenticated-orcid":false,"given":"Jos\u00e9","family":"Rios","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Saavedra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4946-1495","authenticated-orcid":false,"given":"Annabel","family":"Blasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ton","family":"Lisman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Redondo","family":"Figuero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Huelin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Tellez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia Morales","family":"Arr\u00e1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-7668","authenticated-orcid":false,"given":"Manuel","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Aguilera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Arias Loste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6963-9203","authenticated-orcid":false,"given":"Anna","family":"Baiges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Hernandez-Gea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie","family":"Perell\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Calleja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0831-8422","authenticated-orcid":false,"given":"Joan","family":"Genesc\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3674-914X","authenticated-orcid":false,"given":"Candid","family":"Villanueva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0215-4874","authenticated-orcid":false,"given":"Carlos","family":"Gonzalez-Alay\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Albillos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Crespo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9032-4954","authenticated-orcid":false,"given":"Juan Carlos","family":"Garc\u00eda-Pag\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.jhep.2025.06.035_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-1253(19)30349-8","article-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"5","author":"Sepanlou","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.1016\/j.jhep.2025.06.035_bib2","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/S0140-6736(18)31875-0","article-title":"\u03b2 blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial","volume":"393","author":"Villanueva","year":"2019","journal-title":"Lancet"},{"key":"10.1016\/j.jhep.2025.06.035_bib3","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.cgh.2019.05.050","article-title":"Lowering portal pressure improves outcomes of patients with cirrhosis, with or without ascites: a meta-analysis","volume":"18","author":"Turco","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.jhep.2025.06.035_bib4","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.jhep.2021.12.022","article-title":"Baveno VII - Renewing consensus in portal hypertension","volume":"76","author":"De Franchis","year":"2022","journal-title":"J Hepatol"},{"issue":"275","key":"10.1016\/j.jhep.2025.06.035_bib5","doi-asserted-by":"crossref","first-page":"35584","DOI":"10.1074\/jbc.M003188200","article-title":"Thrombin is a potent inducer of connective tissue growth factor production via proteolytic activation of protease-activated receptor-1","volume":"10","author":"Chambers","year":"2000","journal-title":"J Biol Chem"},{"key":"10.1016\/j.jhep.2025.06.035_bib6","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1538-7836.2007.02772.x","article-title":"Coagulation in liver disease group. Hypercoagulation and thrombophilia in liver disease","volume":"6","author":"Northup","year":"2008","journal-title":"J Thromb Haemost"},{"key":"10.1016\/j.jhep.2025.06.035_bib7","first-page":"1232","article-title":"Role of thrombosis in the pathogenesis of congestive hepatic fibrosis (cardiac cirrhosis)","volume":"21","author":"Wanless","year":"1995","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2025.06.035_bib8","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/hep.510270221","article-title":"Expression of the thrombin receptor in human liver: up-regulation during acute and chronic injury","volume":"27","author":"Marra","year":"1998","journal-title":"Hepatology"},{"issue":"333","key":"10.1016\/j.jhep.2025.06.035_bib9","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1042\/bj3330121","article-title":"Thrombin stimulates fibroblast procollagen production via proteolytic activation of protease-activated receptor 1","volume":"1","author":"Chambers","year":"1998","journal-title":"Biochem J"},{"key":"10.1016\/j.jhep.2025.06.035_bib10","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1161\/01.ATV.17.10.1931","article-title":"Thrombin receptor-mediated increase of two matrix metalloproteinases, MMP-1 and MMP-3, in human endothelial cells","volume":"17","author":"Duhamel-Cl\u00e9rin","year":"1997","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"10.1016\/j.jhep.2025.06.035_bib11","doi-asserted-by":"crossref","first-page":"G226","DOI":"10.1152\/ajpgi.00444.2007","article-title":"Protease-activated receptor 1 knockout reduces experimentally induced liver fibrosis","volume":"294","author":"Rullier","year":"2008","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"10.1016\/j.jhep.2025.06.035_bib12","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1136\/gut.2003.032136","article-title":"A role for thrombin in liver fibrosis","volume":"53","author":"Duplantier","year":"2004","journal-title":"Gut"},{"key":"10.1016\/j.jhep.2025.06.035_bib13","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1002\/hep.29084","article-title":"The anticoagulant rivaroxaban lowers portal hypertension in cirrhotic rats mainly by deactivating hepatic stellate cells","volume":"65","author":"Vilaseca","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2025.06.035_bib14","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1053\/j.gastro.2012.07.018","article-title":"Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis","volume":"143","author":"Villa","year":"2012","journal-title":"Gastroenterology"},{"key":"10.1016\/j.jhep.2025.06.035_bib15","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jhep.2023.02.023","article-title":"Baveno Cooperation: an EASL consortium. Anticoagulation improves survival in patients with cirrhosis and portal vein thrombosis: the IMPORTAL competing-risk meta-analysis","volume":"79","author":"Guerrero","year":"2023","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2025.06.035_bib16","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1111\/liv.13285","article-title":"Antithrombotic treatment with direct-acting oral anticoagulants in patients with splanchnic vein thrombosis and cirrhosis","volume":"37","author":"De Gottardi","year":"2017","journal-title":"Liver Int"},{"key":"10.1016\/j.jhep.2025.06.035_bib17","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1002\/hep.31264","article-title":"Mortality and hepatic decompensation in patients with cirrhosis and atrial fibrillation treated with anticoagulation","volume":"73","author":"Serper","year":"2021","journal-title":"Hepatology"},{"issue":"4","key":"10.1016\/j.jhep.2025.06.035_bib18","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1002\/hep4.1513","article-title":"Direct oral anticoagulants in patients with atrial fibrillation and advanced liver disease: an exploratory meta-analysis","volume":"7","author":"Violi","year":"2020","journal-title":"Hepatol Commun"},{"key":"10.1016\/j.jhep.2025.06.035_bib19","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1136\/heartjnl-2013-305288","article-title":"Costa J. Risk of drug-induced liver injury with the new oral anticoagulants: systematic review and meta-analysis","volume":"100","author":"Caldeira","year":"2014","journal-title":"Heart"},{"key":"10.1016\/j.jhep.2025.06.035_bib20","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s40262-013-0034-0","article-title":"Anticoagulant therapy with the oral direct factor Xa inhibitors rivaroxaban, apixaban and edoxaban and the thrombin inhibitor dabigatran etexilate in patients with hepatic impairment","volume":"52","author":"Graff","year":"2013","journal-title":"Clin Pharmacokinet"},{"key":"10.1016\/j.jhep.2025.06.035_bib21","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.jhep.2021.09.003","article-title":"EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis","volume":"76","year":"2022","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2025.06.035_bib22","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1111\/jth.13140","article-title":"Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH","volume":"13","author":"Kaatz","year":"2015","journal-title":"J Thromb Haemost"},{"key":"10.1016\/j.jhep.2025.06.035_bib23","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1007\/s10620-023-07858-9","article-title":"Anticoagulation in patients with liver cirrhosis: friend or Foe?","volume":"68","author":"Protopapas","year":"2023","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.jhep.2025.06.035_bib24","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.dld.2021.07.039","article-title":"Efficacy and safety of direct oral anticoagulants versus vitamin K antagonist for portal vein thrombosis in cirrhosis: a systematic review and meta-analysis","volume":"54","author":"Koh","year":"2022","journal-title":"Dig Liver Dis"},{"key":"10.1016\/j.jhep.2025.06.035_bib25","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1055\/s-0043-1770100","article-title":"Risk of bleeding in liver cirrhosis receiving direct oral anticoagulants: a systematic review and meta-analysis","volume":"123","author":"Li","year":"2023","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.jhep.2025.06.035_bib26","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.jhep.2021.07.020","article-title":"Predicting portal thrombosis in cirrhosis: a prospective study of clinical, ultrasonographic and hemostatic factors","volume":"75","author":"Turon","year":"2021","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2025.06.035_bib27","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/j.cgh.2020.08.007","article-title":"Rates of bleeding and discontinuation of direct oral anticoagulants in patients with decompensated cirrhosis","volume":"19","author":"Mort","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.jhep.2025.06.035_bib28","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/j.cgh.2022.04.024","article-title":"Outcome of budd-chiari syndrome patients treated with direct oral anticoagulants: an Austrian multicenter study","volume":"21","author":"Semmler","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"11","key":"10.1016\/j.jhep.2025.06.035_bib29","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1056\/NEJMoa2209051","article-title":"Rivaroxaban in rheumatic heart disease\u2013associated atrial fibrillation","volume":"387","author":"Connolly","year":"2022","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jhep.2025.06.035_bib30","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1177\/08971900211009075","article-title":"Evaluation of anti-Xa apixaban and rivaroxaban levels with respect to known doses in relation to major bleeding events","volume":"35","author":"Nguyen","year":"2022","journal-title":"J Pharm Pract"}],"container-title":["Journal of Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0168827825023360?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0168827825023360?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T12:55:57Z","timestamp":1772801757000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0168827825023360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["S0168827825023360"],"URL":"https:\/\/doi.org\/10.1016\/j.jhep.2025.06.035","relation":{},"ISSN":["0168-8278"],"issn-type":[{"value":"0168-8278","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Rivaroxaban to prevent complications of portal hypertension in cirrhosis: The CIRROXABAN study","name":"articletitle","label":"Article Title"},{"value":"Journal of Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jhep.2025.06.035","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 European Association for the Study of the Liver. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}