清晨好,您是今天最早来到科研通的研友!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您科研之路漫漫前行!

Prognostic performance of non-invasive tests for portal hypertension is comparable to that of hepatic venous pressure gradient

门静脉压 医学 门脉高压 失代偿 内科学 胃肠病学 门静脉血栓形成 危险系数 肝硬化 心脏病学 置信区间
作者
Mathias Jachs,Lukas Hartl,Benedikt Simbrunner,Georg Semmler,Lorenz Balcar,Benedikt Hofer,Michael Schwarz,Dávid Bauer,Albert Friedrich Stättermayer,Matthias Pinter,Michael Trauner,Thomas Reiberger,Mattias Mandorfer
出处
期刊:Journal of Hepatology [Elsevier]
被引量:2
标识
DOI:10.1016/j.jhep.2023.12.028
摘要

Abstract

Background and Aims

Non-invasive tests (NIT) for assessing the probability of clinically significant portal hypertension (CSPH) including the ANTICIPATE±NASH models based on liver stiffness measurement (LSM), platelet count (PLT)±body mass index (BMI), and the von Willebrand factor antigen (VWF) to PLT ratio (VITRO) have fundamentally changed the management of compensated advanced chronic liver disease (cACLD). However, their prognostic utility has not been compared head-to-head against the hepatic venous pressure gradient (HVPG) as the gold standard.

Methods

cACLD (LSM≥10 kPa) patients who underwent advanced characterization via same-day HVPG/NIT assessment from 2007-2022 were retrospectively included. Long-term follow-up data on hepatic decompensation was recorded.

Results

Four hundred twenty cACLD patients (51.9% viral hepatitis, 20.5% ALD, 18.6% MASLD/MetALD, 9.0% other) with a CSPH prevalence of 67.6% were included. The cumulative incidence of hepatic decompensation at 1 and 2 years were 4.7% and 8.0%, respectively. HVPG, VITRO, and ANTICIPATE±NASH-CSPH-probability showed similar time-dependent prognostic value (AUROC 0.683-0.811 at 1 and 0.699-0.801 at 2 years). In competing risk analyses adjusted for MELD and albumin, HVPG (adjusted subdistribution hazard ratio [aSHR]:1.099 [95%CI:1.054–1.150) per mmHg; p<0.001), or VITRO (aSHR:1.134 [1.062–1.211] per unit; p<0.001), or ANTICIPATE±NASH-CSPH-probability (aSHR:1.232 [1.094–1.387] per 10%; p<0.001) all predicted first decompensation during follow-up. Previously proposed cut-offs (HVPG≥10mmHg vs.<10mmHg, VITRO≥2.5 vs.<2.5, and ANTICIPATE-CSPH probability≥60% vs.<60%) all accurately discriminated between patients at negligible risk and those at substantial risk of hepatic decompensation.

Conclusions

The prognostic performance of ANTICIPATE±NASH-CSPH-probability and VITRO is comparable to that of HVPG, supporting their utility for identifying patients who may benefit from medical therapies for preventing first hepatic decompensation.

Impact and implications

Non-invasive tests (NIT) have revolutionized the diagnosis and management of clinically significant portal hypertension (CSPH) in compensated advanced chronic liver disease (cACLD) patients. However, limited data exists regarding the prognostic utility of NIT in direct comparison to the gold standard for prognostication in cACLD, i.e., the hepatic venous pressure gradient (HVPG). In our study including 420 cACLD patients, HVPG and NIT, i.e., most importantly, the ANTICIPATE±NASH model based on platelet count (PLT) and liver stiffness measurement (LSM), and the von Willebrand factor (VWF) to PLT ratio (VITRO), yielded similar AUROC for hepatic decompensation within one to two years. Thus, NIT should be applied and updated in yearly intervals in clinical routine to identify patients at short-term risk, thereby identifying patients who may benefit from treatment aiming at the prevention of hepatic decompensation.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Jiangshan完成签到 ,获得积分10
14秒前
草履虫的香蕉皮完成签到,获得积分10
36秒前
yw完成签到 ,获得积分20
39秒前
103x完成签到 ,获得积分10
1分钟前
zhangsir完成签到,获得积分10
1分钟前
mahua完成签到 ,获得积分10
2分钟前
btbu2015发布了新的文献求助30
2分钟前
sunflowers完成签到 ,获得积分10
2分钟前
IVY1300完成签到 ,获得积分10
2分钟前
2分钟前
自信小丛完成签到 ,获得积分10
2分钟前
doreen完成签到 ,获得积分10
3分钟前
YUNUN发布了新的文献求助10
4分钟前
SciGPT应助YUNUN采纳,获得10
4分钟前
马帅完成签到 ,获得积分10
5分钟前
平淡的小懒虫完成签到 ,获得积分10
6分钟前
高贵梦秋完成签到,获得积分10
6分钟前
D&L完成签到,获得积分10
6分钟前
cyskdsn完成签到,获得积分20
7分钟前
xwl9955完成签到 ,获得积分10
7分钟前
猪仔5号完成签到 ,获得积分10
8分钟前
iberis完成签到 ,获得积分10
8分钟前
zz完成签到 ,获得积分10
9分钟前
9分钟前
会飞的猪完成签到 ,获得积分10
9分钟前
9分钟前
Lee_Ice完成签到,获得积分10
10分钟前
Wang完成签到 ,获得积分20
10分钟前
Lee_Ice发布了新的文献求助10
10分钟前
爱心完成签到 ,获得积分10
11分钟前
li8888lili8888完成签到 ,获得积分10
11分钟前
NexusExplorer应助Lee_Ice采纳,获得10
11分钟前
爆米花应助武雨寒采纳,获得10
11分钟前
11分钟前
11分钟前
btbu2015发布了新的文献求助30
11分钟前
武雨寒完成签到,获得积分20
12分钟前
武雨寒发布了新的文献求助10
12分钟前
上善若水完成签到 ,获得积分10
12分钟前
12分钟前
高分求助中
Un calendrier babylonien des travaux, des signes et des mois: Séries iqqur îpuš 1036
Sustainable Land Management: Strategies to Cope with the Marginalisation of Agriculture 1000
Corrosion and Oxygen Control 600
Python Programming for Linguistics and Digital Humanities: Applications for Text-Focused Fields 500
Heterocyclic Stilbene and Bibenzyl Derivatives in Liverworts: Distribution, Structures, Total Synthesis and Biological Activity 500
重庆市新能源汽车产业大数据招商指南(两链两图两池两库两平台两清单两报告) 400
Division and square root. Digit-recurrence algorithms and implementations 400
热门求助领域 (近24小时)
化学 材料科学 医学 生物 有机化学 工程类 生物化学 纳米技术 物理 内科学 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 电极 光电子学 量子力学
热门帖子
关注 科研通微信公众号,转发送积分 2545838
求助须知:如何正确求助?哪些是违规求助? 2175672
关于积分的说明 5600226
捐赠科研通 1896383
什么是DOI,文献DOI怎么找? 946268
版权声明 565379
科研通“疑难数据库(出版商)”最低求助积分说明 503557