Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA)
Abstract Nonselective beta‐blockers (NSBBs) may exacerbate ascites by impairing cardiac function. This study evaluated the impact of achieving a heart rate target of 55–60 beats per minute (bpm) on ascites‐related death and complications from worsening ascites in patients with cirrhosis and diuretic...
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ftdoajarticles:oai:doaj.org/article:b68dbbcfc3f5441f9239cd50a9b23ffb 2024-02-27T08:44:19+00:00 Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA) Warunee Mingpun Abhasnee Sobhonslidsuk Supatat Chumnumwat 2024-01-01T00:00:00Z https://doi.org/10.1111/cts.13681 https://doaj.org/article/b68dbbcfc3f5441f9239cd50a9b23ffb EN eng Wiley https://doi.org/10.1111/cts.13681 https://doaj.org/toc/1752-8054 https://doaj.org/toc/1752-8062 1752-8062 1752-8054 doi:10.1111/cts.13681 https://doaj.org/article/b68dbbcfc3f5441f9239cd50a9b23ffb Clinical and Translational Science, Vol 17, Iss 1, Pp n/a-n/a (2024) Therapeutics. Pharmacology RM1-950 Public aspects of medicine RA1-1270 article 2024 ftdoajarticles https://doi.org/10.1111/cts.13681 2024-01-28T01:56:52Z Abstract Nonselective beta‐blockers (NSBBs) may exacerbate ascites by impairing cardiac function. This study evaluated the impact of achieving a heart rate target of 55–60 beats per minute (bpm) on ascites‐related death and complications from worsening ascites in patients with cirrhosis and diuretic‐responsive ascites using NSBBs. A retrospective study was conducted at the Faculty of Medicine Ramathibodi Hospital, Mahidol University (2012–2022) and analyzed patients with cirrhosis and diuretic‐responsive ascites using NSBBs (propranolol/carvedilol) for variceal bleeding prophylaxis. The outcomes were incidence of ascites‐related death and complications from worsening ascites, comparing the achievable target group (heart rate 55–60 bpm) and the unachievable target group (heart rate >60 bpm). A total of 206 patients were included in the study, with a median follow‐up time of 20 months. The patients were divided into an achievable target group (n = 75, median heart rate = 58.0 bpm) and an unachievable target group (n = 131, median heart rate = 73.6 bpm). Propranolol was the most used NSBB (95.1%). The adjusted hazard ratio (HR) for ascites‐related death from spontaneous bacterial peritonitis (SBP) or refractory ascites (RA) or hepatorenal syndrome (HRS) or hepatic encephalopathy (HE) showed no difference between the groups (adjusted HR 0.59 [0.23–1.54]; p = 0.28). Additionally, no significant difference was found in the incidence of complications between groups, including SBP, RA, HRS, and HE. Achieving a heart rate target of 55–60 bpm with NSBBs for variceal bleeding prophylaxis is safe in patients with diuretic‐responsive ascites and cirrhosis. Article in Journal/Newspaper Orca Directory of Open Access Journals: DOAJ Articles Clinical and Translational Science 17 1 |
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Directory of Open Access Journals: DOAJ Articles |
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Therapeutics. Pharmacology RM1-950 Public aspects of medicine RA1-1270 |
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Therapeutics. Pharmacology RM1-950 Public aspects of medicine RA1-1270 Warunee Mingpun Abhasnee Sobhonslidsuk Supatat Chumnumwat Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA) |
topic_facet |
Therapeutics. Pharmacology RM1-950 Public aspects of medicine RA1-1270 |
description |
Abstract Nonselective beta‐blockers (NSBBs) may exacerbate ascites by impairing cardiac function. This study evaluated the impact of achieving a heart rate target of 55–60 beats per minute (bpm) on ascites‐related death and complications from worsening ascites in patients with cirrhosis and diuretic‐responsive ascites using NSBBs. A retrospective study was conducted at the Faculty of Medicine Ramathibodi Hospital, Mahidol University (2012–2022) and analyzed patients with cirrhosis and diuretic‐responsive ascites using NSBBs (propranolol/carvedilol) for variceal bleeding prophylaxis. The outcomes were incidence of ascites‐related death and complications from worsening ascites, comparing the achievable target group (heart rate 55–60 bpm) and the unachievable target group (heart rate >60 bpm). A total of 206 patients were included in the study, with a median follow‐up time of 20 months. The patients were divided into an achievable target group (n = 75, median heart rate = 58.0 bpm) and an unachievable target group (n = 131, median heart rate = 73.6 bpm). Propranolol was the most used NSBB (95.1%). The adjusted hazard ratio (HR) for ascites‐related death from spontaneous bacterial peritonitis (SBP) or refractory ascites (RA) or hepatorenal syndrome (HRS) or hepatic encephalopathy (HE) showed no difference between the groups (adjusted HR 0.59 [0.23–1.54]; p = 0.28). Additionally, no significant difference was found in the incidence of complications between groups, including SBP, RA, HRS, and HE. Achieving a heart rate target of 55–60 bpm with NSBBs for variceal bleeding prophylaxis is safe in patients with diuretic‐responsive ascites and cirrhosis. |
format |
Article in Journal/Newspaper |
author |
Warunee Mingpun Abhasnee Sobhonslidsuk Supatat Chumnumwat |
author_facet |
Warunee Mingpun Abhasnee Sobhonslidsuk Supatat Chumnumwat |
author_sort |
Warunee Mingpun |
title |
Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA) |
title_short |
Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA) |
title_full |
Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA) |
title_fullStr |
Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA) |
title_full_unstemmed |
Optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (ORCA) |
title_sort |
optimal resting heart rate and ascites‐related death in patients with cirrhosis and ascites using nonselective beta‐blockers (orca) |
publisher |
Wiley |
publishDate |
2024 |
url |
https://doi.org/10.1111/cts.13681 https://doaj.org/article/b68dbbcfc3f5441f9239cd50a9b23ffb |
genre |
Orca |
genre_facet |
Orca |
op_source |
Clinical and Translational Science, Vol 17, Iss 1, Pp n/a-n/a (2024) |
op_relation |
https://doi.org/10.1111/cts.13681 https://doaj.org/toc/1752-8054 https://doaj.org/toc/1752-8062 1752-8062 1752-8054 doi:10.1111/cts.13681 https://doaj.org/article/b68dbbcfc3f5441f9239cd50a9b23ffb |
op_doi |
https://doi.org/10.1111/cts.13681 |
container_title |
Clinical and Translational Science |
container_volume |
17 |
container_issue |
1 |
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1792052723146817536 |