Academic Journal
Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
| Title: | Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306) |
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| Authors: | Chuan Liu, Hong You, Qing-Lei Zeng, Yu Jun Wong, Bingqiong Wang, Ivica Grgurevic, Chenghai Liu, Hyung Joon Yim, Wei Gou, Bingtian Dong, Shenghong Ju, Yanan Guo, Qian Yu, Masashi Hirooka, Hirayuki Enomoto, Amr Shaaban Hanafy, Zhujun Cao, Xiemin Dong, Jing LV, Tae Hyung Kim, Yohei Koizumi, Yoichi Hiasa, Takashi Nishimura, Hiroko Iijima, Chuanjun Xu, Erhei Dai, Xiaoling Lan, Changxiang Lai, Shirong Liu, Fang Wang, Ying Guo, Jiaojian Lv, Liting Zhang, Yuqing Wang, Qing Xie, Chuxiao Shao, Zhensheng Liu, Federico Ravaioli, Antonio Colecchia, Jie Li, Gao-Jun Teng, Xiaolong Qi |
| Source: | Clinical and Molecular Hepatology, Vol 31, Iss 1, Pp 105-118 (2025) |
| Publisher Information: | Korean Association for the Study of the Liver, 2025. |
| Publication Year: | 2025 |
| Collection: | LCC:Diseases of the digestive system. Gastroenterology |
| Subject Terms: | cirrhosis, portal hypertension, hepatitis b, carvedilol, Diseases of the digestive system. Gastroenterology, RC799-869 |
| More Details: | Background/Aims Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of 0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2287-2728 2287-285X |
| Relation: | http://e-cmh.org/upload/pdf/cmh-2024-0198.pdf; https://doaj.org/toc/2287-2728; https://doaj.org/toc/2287-285X |
| DOI: | 10.3350/cmh.2024.0198 |
| Access URL: | https://doaj.org/article/68f38ac4ebbc4d29b0bc9cd4f118c001 |
| Accession Number: | edsdoj.68f38ac4ebbc4d29b0bc9cd4f118c001 |
| Database: | Directory of Open Access Journals |
| ISSN: | 22872728 2287285X |
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| DOI: | 10.3350/cmh.2024.0198 |
| Published in: | Clinical and Molecular Hepatology |
| Language: | English |