{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T07:59:46Z","timestamp":1770537586017,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,5,22]],"date-time":"2015-05-22T00:00:00Z","timestamp":1432252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Hypercoagulability has been detected in patients with cirrhosis yet its clinical significance remains unclear. We investigated the association of hypercoagulability with clinical outcomes in patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thrombin\u2013antithrombin (TAT) complexes as thrombin generation (TG) marker, D\u2010dimer, antithrombin (AT), protein C, protein S, international normalized ratio (INR), activated partial thromboplastin time, fibrinogen, Child\u2013Pugh class and Model for End\u2010Stage Liver Disease (MELD) were evaluated. Two different multivariate analyses were performed: one not including MELD (model 1) and one including MELD and excluding INR (model 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010one patients (Child\u2013Pugh class A\/B\/C: 27\/27\/27) and 40 healthy subjects were enrolled. Only \u03a4\u0391\u03a4 and AT were independently associated with increasing liver disease severity. Increased TAT levels and MELD score were significantly associated with ascites and varices at baseline. Independent predictors of follow\u2010up events were: TAT and MELD score for new\u2010onset ascites; TAT and AT for variceal bleeding (VB); TAT and AT for portal vein thrombosis (PVT); and TAT and MELD for mortality. TAT equaled MELD in mortality prediction at 12 and 18\u2009months. TAT cut\u2010offs at 5.35, 14.6, 13.5 and 9.25\u2009ng\/mL identified patient groups with significantly higher probability of new\u2010onset ascites, VB, PVT and mortality, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increased TG is strongly correlated with portal hypertension\u2010related complications, PVT and mortality in patients with cirrhosis. Measuring TG by TAT could enable risk stratification and institution of preventive strategies to improve clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.12520","type":"journal-article","created":{"date-parts":[[2015,4,7]],"date-time":"2015-04-07T01:45:52Z","timestamp":1428371152000},"source":"Crossref","is-referenced-by-count":15,"title":["Thrombin generation measured as thrombin\u2013antithrombin complexes predicts clinical outcomes in patients with cirrhosis"],"prefix":"10.1111","volume":"46","author":[{"given":"Georgios N.","family":"Kalambokis","sequence":"first","affiliation":[{"name":"1st Division of Internal Medicine Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aikaterini","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"Hematology Laboratory Unit of Molecular Biology Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerasimos","family":"Baltayiannis","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Medical School University of Ioannina  Ioannina Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonidas","family":"Christou","sequence":"additional","affiliation":[{"name":"1st Division of Internal Medicine Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos I.","family":"Kolaitis","sequence":"additional","affiliation":[{"name":"Hematology Laboratory Unit of Molecular Biology Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Epameinondas V.","family":"Tsianos","sequence":"additional","affiliation":[{"name":"1st Division of Internal Medicine Medical School"},{"name":"Division of Gastroenterology, Medical School University of Ioannina  Ioannina Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,22]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21303"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011170"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01313579"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)91167-5"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20569"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21266"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.03937.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.08.045"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04182.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00588.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-008-0265-3"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000360514"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.07.018"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1040325"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21563"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.236133"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.143.1.7063747"},{"key":"e_1_2_5_19_1","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1093\/clinchem\/34.10.2058","article-title":"Laboratory and clinical evaluation of an assay of thrombin\u2013antithrombin III complexes in plasma","volume":"34","author":"Hoek JA","year":"1988","journal-title":"Clin Chem"},{"key":"e_1_2_5_20_1","first-page":"874","article-title":"High\u2010D\u2010dimer plasma levels predict poor outcome in esophageal variceal bleeding","volume":"40","author":"Primignani M","year":"2008","journal-title":"Dig Dis Sci"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0049-3848(95)91614-Q"},{"key":"e_1_2_5_22_1","first-page":"305","article-title":"Increased concentrations of tumor necrosis factor and interleukin\u20106 contribute to the hemostatic abnormalities in advanced liver disease","volume":"25","author":"Paramo JA","year":"1995","journal-title":"Haemostasis"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830320107"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0753-3322(93)90084-X"},{"key":"e_1_2_5_25_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1055\/s-0038-1650549","article-title":"Association between high values of D\u2010dimer and tissue\u2010plasminogen activator activity and first gastrointestinal bleeding in cirrhotic patients. 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