THE RISK OF PORTAL VEIN THROMBOSIS IN PATIENTS WITH PORTAL HYPERTENSION TAKING BETA-BLOCKERS: A RETROSPECTIVE COMPARATIVE STUDY FROM A MULTIINSTITUTIONAL DATABASE

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Hepatology

Abstract

Background: Portal vein thrombosis (PVT) involves the obstruction or narrowing of the portal vein due to a blood clot and is commonly associated with liver cirrhosis and portal hypertension. Beta-blockers are frequently prescribed to manage portal hypertension, but their role in the development of PVT is not well understood. This study aims to assess the risk of developing PVT in patients with portal hypertension and liver cirrhosis who are taking beta-blockers compared to those who are not. Methods: This retrospective cohort study used the TriNetX database, which includes electronic health records from over 110 million patients in 63 US healthcare organizations. The study population consisted of adult patients ( ≥ 18 years) with portal hypertension and liver cirrhosis who underwent esophagogastroduodenoscopy with band ligation of esophageal varices, excluding those with liver cell carcinoma. Two cohorts were defined: one receiving beta-blockers (propranolol, carvedilol, or nadolol) and one not receiving beta-blockers. The primary outcome was the incidence of PVT (ICD-10-CM code I81), and the secondary outcome was mortality. Baseline characteristics were balanced using one-to-one propensity score matching (PSM). Outcomes were analyzed using adjusted odds ratios (aOR) with 95% confidence intervals (CI), considering p-values < 0.05 as statistically significant. Results: Before PSM, the beta-blocker cohort included 15,754 patients, and the control cohort included 8,783 patients. After PSM, each cohort had 6,970 patients with similar baseline characteristics. Before PSM, 8.64% of the beta-blocker cohort developed PVT compared to 4.72% in the control group (aOR 1.911, 95% CI 1.693-2.156). After PSM, 8.85% of the beta-blocker cohort developed PVT compared to 4.74% in the control group (aOR 1.951, 95% CI 1.686- 2.257). Mortality was higher in the beta-blocker cohort both before PSM (23.9% vs. 17.37%, aOR 1.494, 95% CI 1.397-1.597) and after PSM (22.8% vs. 18.6%, aOR 1.292, 95% CI 1.190-1.403) . Conclusion: Beta-blocker use in patients with portal hypertension and liver cirrhosis is associated with a significantly higher risk of developing PVT and increased mortality. Further research is needed to explore these associations and assess the safety of beta-blockers in this patient population. (Figure Presented).

Volume

80

First Page

S3

Find It @ Sladen

Share

COinS