Z Gastroenterol 2023; 61(08): e471-e472
DOI: 10.1055/s-0043-1771852
Abstracts | DGVS/DGAV
Kurzvorträge
Zirrhosekomplikationen I – Inflammation und Infektion
Donnerstag, 14. September 2023, 12:55–14:39, Saal C2.1

Impact of concomitant cardiovascular medications on overall survival in patients with liver cirrhosis

M. Li
1   Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Deutschland
,
T. Itzel
1   Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Deutschland
,
N. Espinosa Montagut
2   School of Medicine, Universidad de los Andes,Bogotá, Colombia, Bogota, Kolumbien
,
T. Falconer
3   Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, Vereinigte Staaten
,
J. Daza
1   Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Deutschland
,
J. Park
4   Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Korea, Republik
,
J. Y. Cheong
5   Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea, Republik
,
R. W. Park
6   Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea, Republik
,
I. Wiest
1   Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Deutschland
,
M. Ebert
1   Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Deutschland
,
G. Hripcsak
3   Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, Vereinigte Staaten
,
A. Teufel
1   Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Deutschland
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    Background & Aims Liver cirrhosis is the end-stage liver disease associated with poor prognosis. Cardiovascular comorbidity could significantly impact morbidity and mortality of cirrhotic patients. However, little knowledge exists for specific impact of diverse concomitant cardiovascular drugs in cirrhotic patients. Here, we conducted a large, retrospective study to investigate the survival impact of cardiovascular co-medications in patients with liver cirrhosis.

    Methods A study-specific R package was processed on the local databases of partner institutions within the Observational Health Data Sciences and Informatics (OHDSI) consortium, namely Columbia University, New York City (NYC), U.S.A. and Ajou University School of Medicine (AUSOM), South Korea. For survival analysis, first diagnosis of cirrhosis was limited between 2000 and 2020. Final analysis of the anonymous survival data was performed at the Medical Faculty Mannheim.

    Results We investigated a total of 32,366 patients with liver cirrhosis. Our data showed that administration of antiarrhythmics amiodarone or digoxin presented as a negative prognostic indicator (p=0.000 in both cohorts). Improved survival was associated with angiotensin-converting enzyme inhibitor ramipril (p=0.005 in NYC cohort, p=0.075 in AUSOM cohort) and angiotensin II receptor blocker losartan (p=0.000 in NYC cohort, p=0.005 in AUSOM cohort). Non-selective beta blocker carvedilol was associated with a survival advantage in the NYC (p=0.000) cohort but not in the AUSOM cohort (p=0.142). Patients who took platelet inhibitor clopidogrel had a prolonged overall survival compared to those without (p=0.000 in NYC cohort, p=0.003 in AUSOM cohort).

    Conclusion Liver cirrhosis is a complex chronic disease requiring multidisciplinary management. Concomitant cardiovascular medications used in cirrhotic patients are associated with distinct survival difference. Thus, a judicious choice of the proper cardiovascular co-medication in patients with cirrhosis is crucial.


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    Publication History

    Article published online:
    28 August 2023

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