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Open AccessArticle

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

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Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83330, Taiwan
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Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83330, Taiwan
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Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
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Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
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School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83330, Taiwan
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School of Pharmacy, Kaohsiung Medical University, Kaohsiung 80700, Taiwan
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Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83330, Taiwan
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Author to whom correspondence should be addressed.
Medicina 2020, 56(1), 14; https://doi.org/10.3390/medicina56010014
Received: 21 November 2019 / Revised: 22 December 2019 / Accepted: 22 December 2019 / Published: 30 December 2019
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. View Full-Text
Keywords: cirrhotic patients without major complications; clinically significant portal hypertension; propranolol cirrhotic patients without major complications; clinically significant portal hypertension; propranolol
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Yeh, W.-S.; Yang, S.-C.; Liang, C.-M.; Li, Y.-C.; Tai, W.-C.; Lee, C.-H.; Yang, Y.-H.; Hsu, C.-N.; Tsai, T.-H.; Chuah, S.-K.; Wu, C.-K. The Role of Non-Selective β-Blockers in Compensated Cirrhotic Patients without Major Complications. Medicina 2020, 56, 14.

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