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Nonselective beta‐blockers reduce mortality in patients with acute‐on‐chronic liver failure

Portal Hypertension & Cirrhosis 2022年第1期1卷 15-22页

作者： Anand V.Kulkarni Madhumita Premkumar Karan Kumar Juned A.Khan Baqar A.Gora Sowmya Tirumalle Sameer Shaik Mithun Sharma Rajesh Gupta Nageshwar D.Reddy Padaki N.Rao Department of Hepatology AIG HospitalsHyderabadIndia Department of Hepatology PGIMERChandigarhIndia Department of Hepatology Mahatma Gandhi HospitalsJaipurIndia Department of Hepatology Hopewell HospitalLucknowIndia

Aim:Nonselective beta‐blockers(NSBBs)can reduce the incidence of complications in patients with cirrhosis and prolong *** safety and efficacy of NSBBs in real‐world settings in patients with acute‐on‐chronic liver failure(ACLF)identified by the Asian Pacific Association for the Study of Liver criteria are *** study aimed to assess the safety and efficacy of NSBBs in patients with Asian Pacific Association for the Study of Liver(APASL)‐defined ACLF Methods:In this retrospective,multicenter study,patients with ACLF with complete 30 days follow‐up from January 2019 to December 2021 were *** primary objective was to compare 30‐day mortality among standard of care(SOC)and NSBB(+SOC)*** secondary objectives were to compare the incidence of infection,variceal bleed,and recompensation among both the ***:A total of 346 patients were *** 26%(n=89)of them received NSBBs,while 74%(n=257)received only *** Kaplan-Meier analysis,the incidence of mortality was 21%(95%confidence interval[CI]:16.20-26.50)in SOC group compared to only 8%(95%CI:3.22-15.53)in NSBB group at Day 30(p=0.005).Similarly,mortality in SOC group was 63%(95%CI:56.81-69.00)compared to 46%(95%CI:35.44-57.00)in NSBB group at 1 year(p=0.001).NSBB therapy could not reduce the incidence of infections or variceal ***‐seven percent of patients in the SOC group and 73%of patients in the NSBB group(pvariceal bleed in patients with ***,only one in four ACLF patients are suitable for NSBB therapy.

关键词： ACLF infection portal hypertension variceal bleed

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