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. 2019 Dec 30;56(1):14.
doi: 10.3390/medicina56010014.

The Role of Non-Selective β-Blockers in Compensated Cirrhotic Patients without Major Complications

Wen-Shuo Yeh  1 , Shih-Cheng Yang  1 , Chih-Ming Liang  1 , Yu-Chi Li  1 , Wei-Chen Tai  1 , Chen-Hsiang Lee  2 , Yao-Hsu Yang  3   4   5 , Chien-Ning Hsu  6   7 , Tzu-Hsien Tsai  8 , Seng-Kee Chuah  1 , Cheng-Kun Wu  1
Affiliations

The Role of Non-Selective β-Blockers in Compensated Cirrhotic Patients without Major Complications

Wen-Shuo Yeh et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Non-selective β-blockers (NSBB) could prevent decompensation and hepatocellular carcinoma (HCC) in cirrhotic patients with clinically significant portal hypertension (CSPH), but remained uncertain for compensated cirrhotic patients without major complications. We aimed to compare the clinical outcomes between propranolol users and non-users of a CC group without major complications. Material and Methods: We conducted this population-based cohort study by using the Taiwanese Longitudinal Health Insurance Database 2000. Propranolol users (classified as cumulative defined daily dose (cDDD)) and non-PPL users were matched with a 1:1 propensity score in both cohorts. Results: This study comprised 6896 propranolol users and 6896 non-propranolol users. There was no significant impact on the development of spontaneous bacterial peritonitis between the two groups (aHR: 1.24, 95% confidence interval (CI): 0.88~1.75; p = 0.2111). Male gender, aged condition, and non-liver related diseases (peripheral vascular disease, cerebrovascular disease, dementia, pulmonary disease, and renal disease) were the independent risk factors of mortality. PPL users had significantly lower incidence of HCC development than non-users (aHR: 0.81, p = 0.0580; aHR: 0.80, p = 0.1588; and aHR: 0.49, p < 0.0001 in the groups of 1-28, 29-90, and >90 cDDD, respectively). Conclusion: The current study suggested that high cumulative doses of propranolol could decrease the risk of hepatocellular carcinoma among compensated cirrhotic patients without major complications. Further large-scale prospective studies are still required to confirm the findings in this study. Results: It remained uncertain whether non-selective β-blockers (NSBB) could prevent decompensation and hepatocellular carcinoma (HCC) in compensatory cirrhotic patients without major complications. This study aimed to compare the clinical outcomes between propranolol users and non-users of the CC group without major complications.

Keywords: cirrhotic patients without major complications; clinically significant portal hypertension; propranolol.

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Conflict of interest statement

The authors declared no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic flowchart of the study design.
Figure 2
Figure 2
Cumulative incidence of spontaneous bacterial peritonitis between the groups.
Figure 3
Figure 3
Cumulative incidence of all-cause mortality between the groups.
Figure 4
Figure 4
Cumulative incidence of hepatocellular carcinoma between the groups.
See this image and copyright information in PMC

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