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.

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.

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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...

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... outcomes: bleeding/decompensation during 2 years of follow-up - Fig. 3 ...

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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.