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Nonselective Beta-Blocker Associated With Decreased Mortality in Patients With Gastric Varices.
Rebecca H Moon1, Joanie Chung2, Paul Chang3
1Department of Gastroenterology, Graduate Medical Education, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
Gastro Hep Advances
|June 23, 2025
Summary
Nonselective beta-blockers (NSBBs) may reduce mortality in patients with gastric varices (GV). This study found lower mortality rates in GV patients using NSBBs compared to nonusers, suggesting a potential prognostic benefit.
Area of Science:
- Hepatology
- Gastroenterology
- Clinical Pharmacology
Background:
- Gastric varices (GV) are a serious complication of portal hypertension with higher mortality than esophageal varices.
- Efficacy of nonselective beta-blockers (NSBBs) for preventing gastric variceal hemorrhage is not well-established.
- Limited data exists on the impact of NSBBs on clinical outcomes in patients with GV.
Purpose of the Study:
- To investigate the impact of nonselective beta-blockers (NSBBs) on clinical outcomes in patients diagnosed with gastric varices (GV).
- To compare mortality and other clinical outcomes between NSBB users and nonusers with GV.
Main Methods:
- Retrospective cohort study of 1276 patients with GV diagnosed between 2015 and 2021.
- Comparison of outcomes including hemorrhage, liver transplantation, shunt placement, and mortality between NSBB users and nonusers.
- Multivariate logistic regression analyses were used to compare outcomes.
Main Results:
- Mortality was significantly lower in the NSBB group (39.2%) compared to the non-NSBB group (50.9%) (OR = 0.62).
- No significant differences were observed between groups for gastric variceal hemorrhage, esophageal variceal hemorrhage, liver transplantation, or shunt placement.
- The overall mortality rate at study completion was 40.1%.
Conclusions:
- Nonselective beta-blocker (NSBB) use in patients with gastric varices (GV) is associated with reduced mortality.
- NSBBs may offer a prognostic benefit in the management of patients with GV in real-world settings.
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