Model validation of guiding carvedilol therapy in a longitudinal carvedilol-treating cohort
Among 114 patients receiving carvedilol in the retrospective cohort, 51 (44.7%) were categorized in high-risk CSPH based on the novel model (sFigure 3c, sTable 3). Compared to high-risk CSPH patients who did not receive NSBBs (n=613), those who received carvedilol were younger and had less advanced liver diseases, as indicated by lower baseline serum albumin and higher LSM (sTable 3). After PSM in a 2:1 ratio, the baseline characteristics were well-balanced between cirrhotic patients with carvedilol and without NSBBs.
Notably, treatment with carvedilol was associated with a significantly lower cumulative incidence of 3-year decompensation (p=0.02) (Figure 4A). After PSM, the cumulative incidence of decompensation remained significantly lower in cirrhotic patients treated with carvedilol (p=0.03) (Figure 4B). Furthermore, the high-risk CSPH patients treated with carvedilol had significantly lower incidence of ascites than those of NSBBs untreated high-risk CSPH patients before and after PSM (all p<0.05, sFigure 6).