Transplant-free survival stratified according to (A) Child-Pugh stage, (B) MELD, (C) HVPG-strata and (D) NSBB-response.

Transplant-free survival stratified according to (A) Child-Pugh stage, (B) MELD, (C) HVPG-strata and (D) NSBB-response.

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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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Context 1
... outcomes: Transplant-free survival (TFS) during 2 years of follow-up - Fig. 4 A-D Within 2 years of follow-up, n = 5 patients died. CPS (CPS A vs. B: p = 0.129, A vs. C: 0.042, B vs. C: 0.455; Kaplan-Meier Survival Estimates: CPS A: 94%, CPS B: 83%, CPS C: 53%) and MELD ≥15/ < 15 ( p = 0.004; Kaplan-Meier Survival Estimates: MELD < 15: 92%, MELD ≥15: 68%) were good indicators for predicting TFS. However, both ...

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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.