Platelet Function Abnormalities in Patients with Liver Cirrhosis and Esophageal Varices

Background: Severe thrombocytopenia and platelet dysfunctions are common amongst patients with cirrhosis and can contribute to increase risk of bleeding in patient with cirrhosis and portal hypertension (PH).Many studies confirmed the close association between thrombocytopenia and accordance of variceal bleeding.But the relationship of platelet function disorder and risk of variceal bleeding is still a matter of debate.Objectives: This study aimed to evaluate effect of platelet count, platelets indices and platelet functions in cirrhotic patients with different grade of oesophageal varices (OV) and identifying potential risk factors associated with variceal bleeding.Patients and methods: 60 cirrhotic patients with different grades of OV were included in the study, 30 of them had a history of variceal bleeding and 30 patients never bled as well as 30 apparently healthy control subjects.They were subjected to laboratory investigations including: liver function tests, coagulation tests, platelet count, platelet indices and platelet function assessment using light transmission aggregometry.Results: The collagen corrected area at cut off point ≥ 0.76 (AUC=0.832),with a sensitivity of 70% and a specificity of 96.7%.Ristocetin corrected area at cut off point ≥ 0.76 (AUC=0.832)with a sensitivity of 66.7% and a specificity of 93.3% but ADP had a poor diagnostic performance as ADP corrected area at cut off point ≥ 0.51 (AUC=0.646)sensitivity is 53.3% and specificity 90%.Conclusion: The corrected areas of ADP, collagen, and ristocetin were significantly associated with risk of OV bleeding, in which the corrected area of collagen and ristocetin were good diagnostic markers and superior to ADP for prediction of bleeders OV group.