Exploring algorithms to select candidates for non-selective beta-blockers in cirrhosis : A post hoc analysis of the PREDESCI trial
Dajti, Elton (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Villanueva, Càndid (Institut de Recerca Sant Pau)
Berzigotti, A. (University Hospital Bern)
Brujats Rubirola, Anna (Institut de Recerca Sant Pau)
Albillos, Agustín (Instituto Ramón y Cajal de Investigación Sanitaria (Madrid))
Genescà Ferrer, Joan (Hospital Universitari Vall d'Hebron)
García-Pagán, JC. (Hospital Clínic i Provincial de Barcelona)
Colecchia, A. (Azienda Ospedaliero-Universitaria di Modena and University of Modena and Reggio Emilia)
Bosch, Jaume (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Date:	2025
Abstract:	Background & Aims: Whether non-invasive tests (NITs) can accurately select patients with cirrhosis requiring non-selective beta-blockers (NSBBs) for clinically significant portal hypertension (CSPH) and prevention of decompensation is unclear. Our aim was to test the performance of NIT-based algorithms for CSPH diagnosis using the prospective PREDESCI cohort. We investigated whether a new algorithm combining NITs with endoscopy could improve performance. Methods: We included patients with compensated cirrhosis and available liver elastography who were screened during the trial. The performance of models based on liver stiffness measurement (LSM) and platelet count was evaluated. An algorithm considering endoscopy for patients with inconclusive results (the "grey zone") was then developed and validated in an independent cohort of 195 patients in whom spleen stiffness was also available. Results: We included 170 patients from the PREDESCI cohort. An LSM ≥25 kPa alone (Baveno VII criteria) or combined with an LSM.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Carvedilol ; Decompensation ; Elastography ; Liver stiffness ; Portal hypertension ; Spleen stiffness
Published in:	Journal of hepatology, Vol. 82 Núm. 3 (march 2025) , p. 490-498, ISSN 1600-0641

DOI: 10.1016/j.jhep.2024.09.014
PMID: 39303875

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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