Systemic arterial blood pressure determines the therapeutic window of non-selective beta blockers in decompensated cirrhosis

Alimentary Pharmacology & Therapeutics
Tammo L TergastBenjamin Maasoumy

Abstract

The safety of non-selective β-blockers in patients with advanced cirrhosis has been questioned in recent years. It was hypothesised that there is a particular therapeutic window. However, the specific limits still need to be determined. To evaluate potential limits of the therapeutic window of non-selective β-blocker therapy in patients with cirrhosis and ascites METHODS: The impact of non-selective β-blockers on 28-day transplant-free survival was analysed in a cohort of 624 consecutive patients with decompensated cirrhosis and ascites. Three potential limits were investigated: spontaneous bacterial peritonitis, acute-on-chronic liver failure, mean arterial blood pressure ≤ 82 and < 65 mm Hg. Treatment with non-selective β-blockers was associated with a higher 28-day transplant-free survival in the overall cohort (hazard ratio: 0.621; P = .035) as well as in patients with acute-on-chronic liver failure (hazard ratio: 0.578; P = .031) and those with spontaneous bacterial peritonitis (hazard ratio: 0.594; P = .073). In contrast, survival benefits were markedly attenuated in patients with a mean arterial blood pressure ≤ 82 mm Hg and completely lost in those with mean arterial blood pressure < 65 mm Hg (P = .536). In spontaneous ...Continue Reading

References

Dec 29, 1999·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·M Pérez-ParamoJ Ortiz-Berrocal
Feb 15, 2001·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·P S KamathW R Kim
Jun 24, 2005·Intensive Care Medicine·Marjut VarpulaVille Pettilä
Jun 29, 2010·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Thomas SerstéDidier Lebrec
Jun 4, 2011·Zeitschrift für Gastroenterologie·A L GerbesM Schepke
Dec 25, 2012·Journal of Hepatology·Thomas ReibergerUNKNOWN Vienna Hepatic Hemodynamic Lab
Feb 26, 2013·Statistics in Medicine·Deborah Kuk, Ravi Varadhan
Mar 12, 2013·Gastroenterology·Richard MoreauUNKNOWN CANONIC Study Investigators of the EASL–CLIF Consortium
Aug 10, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Anne RobinsWilliam Griffiths
Apr 29, 2014·Gastroenterology·Phillip S Ge, Bruce A Runyon
Jan 23, 2015·Liver International : Official Journal of the International Association for the Study of the Liver·Thomas SerstéChristophe Moreno
Nov 1, 2015·Journal of Hepatology·Rajeshwar P MookerjeeUNKNOWN CANONIC Study Investigators of the EASL-CLIF Consortium
Nov 26, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Lars BossenPeter Jepsen
Jan 3, 2016·Journal of Hepatology·Guadalupe Garcia-Tsao
Feb 5, 2016·Journal of Hepatology·Bjørn Stæhr MadsenAleksander Krag
Mar 19, 2016·Liver International : Official Journal of the International Association for the Study of the Liver·Ulrich C BangFlemming Bendtsen
Oct 28, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Guadalupe Garcia-TsaoJaime Bosch
Nov 20, 2016·Journal of Hepatology·Thomas Reiberger, Mattias Mandorfer
Mar 16, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Simona OnaliEmmanuel A Tsochatzis
Nov 8, 2017·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Mattias Mandorfer, Thomas Reiberger
Apr 15, 2018·Journal of Hepatology·UNKNOWN European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, UNKNOWN European Association for the Study of the Liver
Apr 21, 2018·Liver International : Official Journal of the International Association for the Study of the Liver·Tammo L TergastBenjamin Maasoumy

❮ Previous
Next ❯

Citations

Dec 8, 2019·The Annals of Pharmacotherapy·Amanda C BultasWilliam B Call
Oct 9, 2019·Alimentary Pharmacology & Therapeutics·Tammo L Tergast, Benjamin Maasoumy
Oct 9, 2019·Alimentary Pharmacology & Therapeutics·Mattias Mandorfer, Thomas Reiberger
Sep 3, 2020·European Journal of Internal Medicine·Christian LabenzMarcus-Alexander Wörns
May 28, 2021·Journal of Hepatology·Juan Carlos Garcia-PaganRajeshwar P Mookerjee
May 28, 2021·Journal of Hepatology·William BernalPhilippe Meersseman
Jul 28, 2021·The American Journal of Gastroenterology·Fei-Pi LinAndrés Duarte-Rojo
Jul 14, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Mathias JachsMattias Mandorfer
Aug 10, 2021·World Journal of Hepatology·Nikolaus PfistererThomas Reiberger
Jun 14, 2020·La Revue de médecine interne·T Bejan-Angoulvant, D Angoulvant

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Nature Reviews. Gastroenterology & Hepatology
Juan Carlos Garcia-Pagán
Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
A FerrareseM Senzolo
© 2021 Meta ULC. All rights reserved