Clinical and Molecular Hepatology (Jan 2025)
Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
- Chuan Liu,
- Hong You,
- Qing-Lei Zeng,
- Yu Jun Wong,
- Bingqiong Wang,
- Ivica Grgurevic,
- Chenghai Liu,
- Hyung Joon Yim,
- Wei Gou,
- Bingtian Dong,
- Shenghong Ju,
- Yanan Guo,
- Qian Yu,
- Masashi Hirooka,
- Hirayuki Enomoto,
- Amr Shaaban Hanafy,
- Zhujun Cao,
- Xiemin Dong,
- Jing LV,
- Tae Hyung Kim,
- Yohei Koizumi,
- Yoichi Hiasa,
- Takashi Nishimura,
- Hiroko Iijima,
- Chuanjun Xu,
- Erhei Dai,
- Xiaoling Lan,
- Changxiang Lai,
- Shirong Liu,
- Fang Wang,
- Ying Guo,
- Jiaojian Lv,
- Liting Zhang,
- Yuqing Wang,
- Qing Xie,
- Chuxiao Shao,
- Zhensheng Liu,
- Federico Ravaioli,
- Antonio Colecchia,
- Jie Li,
- Gao-Jun Teng,
- Xiaolong Qi
Affiliations
- Chuan Liu
- Liver Disease Center of Integrated Traditional Chinese and Western Medicine, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing, China
- Hong You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, State Key Lab of Digestive Health, National Clinical Research Center of Digestive Diseases, Beijing, China
- Qing-Lei Zeng
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore
- Bingqiong Wang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, State Key Lab of Digestive Health, National Clinical Research Center of Digestive Diseases, Beijing, China
- Ivica Grgurevic
- University Hospital Dubrava, University of Zagreb School of Medicine and Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
- Chenghai Liu
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Korea University Ansan Hospital, Ansan, Korea
- Wei Gou
- Qingdao Sixth People’s Hospital, Qingdao, China
- Bingtian Dong
- Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Shenghong Ju
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
- Yanan Guo
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Qian Yu
- Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Masashi Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
- Hirayuki Enomoto
- Division of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
- Amr Shaaban Hanafy
- Division of Gastroenterology, Hepatology and Endoscopy, Internal Medicine, Zagazig University Faculty of Medicine, Zagazig, Egypt
- Zhujun Cao
- Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xiemin Dong
- Qingdao Sixth People’s Hospital, Qingdao, China
- Jing LV
- Department of Liver Disease, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tae Hyung Kim
- Division of Gastroenterology and Hepatology, Korea University Ansan Hospital, Ansan, Korea
- Yohei Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
- Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
- Takashi Nishimura
- Division of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
- Hiroko Iijima
- Division of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
- Chuanjun Xu
- Department of Radiology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
- Erhei Dai
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Shijiazhuang, China
- Xiaoling Lan
- Department of Infectious Diseases, Lishui People’s Hospital, Lishui, China
- Changxiang Lai
- Shenzhen Third People’s Hospital, Shenzhen, China
- Shirong Liu
- Department of Infectious Diseases, Qufu People’s Hospital, Qufu, China
- Fang Wang
- Shenzhen Third People’s Hospital, Shenzhen, China
- Ying Guo
- Department of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, China
- Jiaojian Lv
- Department of Infectious Diseases, Lishui People’s Hospital, Lishui, China
- Liting Zhang
- Department of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou, China
- Yuqing Wang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
- Qing Xie
- Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Chuxiao Shao
- Lishui People’s Hospital, Lishui, China
- Zhensheng Liu
- Qingdao Sixth People’s Hospital, Qingdao, China
- Federico Ravaioli
- Gastroenterology Unit, University Hospital of Modena, Department of Medical Specialities, University of Modena & Reggio Emilia, Modena, Italy
- Antonio Colecchia
- Gastroenterology Unit, University Hospital of Modena, Department of Medical Specialities, University of Modena & Reggio Emilia, Modena, Italy
- Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Gao-Jun Teng
- Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University; State Key Laboratory of Digital Medical Engineering, Nanjing, China
- Xiaolong Qi
- Liver Disease Center of Integrated Traditional Chinese and Western Medicine, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing, China
- DOI
- https://doi.org/10.3350/cmh.2024.0198
- Journal volume & issue
-
Vol. 31,
no. 1
pp. 105 – 118
Abstract
Background/Aims Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of 0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.
Keywords
