Outcomes in patients with venous thromboembolism: does cirrhosis matter?

The total incidence of venous thromboembolism (VTE) in the United States is unknown, but it is thought to affect approximately 300,000–600,000 people each year (1). The incidence of VTE in patients with chronic liver disease (CLD) or cirrhosis has been reported to be anywhere from 0.2% to 6.3% (2-10). The liver plays a key role in the coagulation process by synthesizing both procoagulant and anticoagulant factors. Thus, coagulation abnormalities are to be expected in cirrhosis. Over the last ten years, a shift in the understanding of the hemostatic balance has occurred and it is now well known that patients with cirrhosis are not protected from VTE as once was thought (11,12).