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Nonselective beta blockers tied to portal vein thrombosis in cirrhotic patients

08 Feb 2019

Exposure to nonselective beta blockers contributes to an increased risk of developing portal vein thrombosis in patients with cirrhosis, a study suggests.

The study included 97 outpatients with cirrhosis and no portal vein thrombosis at baseline, of whom 50 percent were on nonselective beta blockers. Researchers performed Doppler ultrasound every 3 or 6 months for a median follow up of 19 months.

Portal vein thrombosis occurred in 11 patients (10.2 percent) during follow-up. Occlusion of the portal vein was complete in two patients and partial in nine. Most of the patients were male (54.6 percent male) and had Child-Pugh A cirrhosis (81.8 percent).

Significant risk factors for incident portal vein thrombosis included nonselective beta blockade (hazard ratio [HR], 10.56; 95 percent CI, 1.35–82.73; p=0.025) and a history of medium- or large‐sized oesophageal varices at baseline (HR, 5.67; 1.49–21.63; p=0.011).

Conversely, heart rate and portal blood flow velocity at baseline showed no association with the risk of portal vein thrombosis, although the two variables were significantly improved by nonselective beta blockers.

Researchers pointed out the need for further investigation to characterize the mechanisms that explain portal vein thrombosis development in cirrhotic patients on nonselective beta blockers in order to optimize targeting of nonselective beta blockers in this population.

Nonselective beta blockers is the gold standard in the prevention of first and recurrent variceal bleeding. The goal is to lower portal hypertension through β1 receptor blockade, which reduces cardiac output, and β2 receptor blockade, which causes splanchnic vasoconstriction. It has been postulated that β1 and β2 blockade may lead to portal vein thrombosis development by reducing portal vein inflow and portal flow velocity. [World J Gastroenterol 2014;20:11463‐11466; Expert Opin Pharmacother 2003;4:625‐637]

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Most Read Articles
20 Jun 2020
The Lundbeck Neuroscience Symposium was held at Sofitel KL Damansara over 2 days, with extensivediscussions on the management of various mental illnesses. The second day of the symposiumaddressed the topic of schizophrenia management, focusing on treatment goals, the rationale forpartial dopamine D(2) receptor agonism and the use of long-acting injectable (LAI) antipsychotics topromote adherence.
Pearl Toh, 4 days ago
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
3 days ago
Patients with psoriatic arthritis (PsA) often suffer from liver abnormalities, which are associated with higher body mass index (BMI), daily consumption of alcohol, more severe disease, and some therapies, according to a recent study.
Christina Lau, 2 days ago

Pembrolizumab in combination with chemotherapy significantly improves progression-free survival (PFS) vs chemotherapy alone in patients with previously untreated, locally recurrent inoperable or metastatic triple-negative breast cancer (TNBC), results of the KEYNOTE-355 study have shown.