Fig 3 - available via license: Creative Commons Attribution 4.0 International
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Incidence of the composite endpoint bleeding/decompensation after 24 months according to (A) Child-Pugh-Stage, (B) MELD, (C) HVPG, and HVPG-response and occurrence of (D) any decompensation or (E) variceal (re)-bleeding only.
Source publication
Background and Aims
Non-alcoholic steatohepatitis has become a leading cause of cirrhosis. The prognostic value of (HVPG)-guided NSBB prophylaxis remains to be investigated in the setting of NASH cirrhosis.
Methods
Patients with NASH cirrhosis and varices undergoing HVPG-guided NSBB therapy were included. HVPG-response to NSBBs was evaluated withi...
Context in source publication
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Objective
Clinical evidence suggests that the risk stratification of portal hypertension (PH) plays a vital role in disease progression and patient outcomes. However, the gold standard for stratifying PH [portal vein pressure (PVP) measurement] is invasive and therefore not suitable for routine clinical practice. This study is aimed to stratify PH...
Citations
In the recently published original article by Paternostro et al., analyzing the prognostic value of HVPG-response to (NSBB) in patients with NASH-related cirrhosis and varices, the authors reported that 55.3% of the patients achieved HVPG-response to NSBB. Presence of diabetes (adjusted odds ratio (aOR) 0.16, p = 0.038) and baseline mean arterial pressure (MAP) (aOR:1.07, p = 0.044) were independent predictors of NSBB- response. Child-Pugh stage B/C, MELD ≥ 15, and HVPG ≥ 20 mmHg but not HVPG response, predicted the composite endpoint of bleeding or decompensation at 90 days and 2 years. While this study adds to the limited existing literature on efficacy and outcomes of NSBB induced HVPG-response in patients with NASH cirrhosis, some issues need to be addressed.
