Portal Vein Thrombosis Risk in Cirrhotic Patients With Portal Hypertension on Beta-Blockers: A Multi-Institutional Cohort Study.
H, A., K, E., M, A., A, I., A, O., AE, A., A, O., V, R., M, N., & M, E.K. (2026). Portal Vein Thrombosis Risk in Cirrhotic Patients With Portal Hypertension on Beta-Blockers: A Multi-Institutional Cohort Study.. Liver international : official journal of the International Association for the Study of the Liver. https://doi.org/10.1111/liv.70843
H A, K E, M A, A I, A O, AE A, et al. Portal Vein Thrombosis Risk in Cirrhotic Patients With Portal Hypertension on Beta-Blockers: A Multi-Institutional Cohort Study.. Liver international : official journal of the International Association for the Study of the Liver. 2026; doi: 10.1111/liv.70843
H A, K E, M A, et al. Portal Vein Thrombosis Risk in Cirrhotic Patients With Portal Hypertension on Beta-Blockers: A Multi-Institutional Cohort Study.[J]. Liver international : official journal of the International Association for the Study of the Liver. 2026. DOI: 10.1111/liv.70843.
@article{h2026,
author = {Abosheaishaa H and Elfert K and Abusuliman M and Ismail A and Olimy A and Alzamzamy AE and Omran A and Rizzo V and Nassar M and El-Kassas M},
title = {Portal Vein Thrombosis Risk in Cirrhotic Patients With Portal Hypertension on Beta-Blockers: A Multi-Institutional Cohort Study.},
journal = {Liver international : official journal of the International Association for the Study of the Liver},
year = {2026},
doi = {10.1111/liv.70843},
note = {PMID: 42642993},
}
TY - JOUR AU - Abosheaishaa H AU - Elfert K AU - Abusuliman M AU - Ismail A AU - Olimy A AU - Alzamzamy AE AU - Omran A AU - Rizzo V AU - Nassar M AU - El-Kassas M TI - Portal Vein Thrombosis Risk in Cirrhotic Patients With Portal Hypertension on Beta-Blockers: A Multi-Institutional Cohort Study. T2 - Liver international : official journal of the International Association for the Study of the Liver PY - 2026 DO - 10.1111/liv.70843 AN - PMID:42642993 ER -
BACKGROUND: Portal vein thrombosis (PVT) is a significant complication of cirrhosis. Nonselective beta-blockers (NSBBs) are standard therapy for portal hypertension, but their effect on PVT risk remains uncertain. AIM: To assess whether NSBB use after variceal band ligation increases PVT risk and to compare outcomes among propranolol, carvedilol and no NSBB therapy. METHODS: We conducted a retrospective cohort study using the TriNetX US Collaborative Network (> 110 million patients). Adults with cirrhosis and portal hypertension who underwent variceal band ligation (2010-2024) were included. Patients were stratified by NSBB exposure and matched 1:1 on 12 clinical variables. The primary outcome was incident PVT; secondary outcome was all-cause mortality. Kaplan-Meier analysis evaluated time-to-event outcomes. RESULTS: After matching (n = 4296 per group), NSBB use was associated with higher PVT incidence compared with no NSBBs (9.5% vs. 5.4%; RR 1.765, 95% CI 1.500-2.077). Propranolol was associated with increased PVT risk, whereas carvedilol showed similar PVT incidence to controls and significantly lower mortality compared with both propranolol and no NSBB use. CONCLUSIONS: Propranolol use was linked to increased PVT risk, while carvedilol did not elevate PVT risk and was associated with improved survival. Beta-blocker selection may meaningfully influence outcomes in cirrhosis. In patients with liver cirrhosis, beta‐blockers are commonly used to reduce complications related to high blood pressure in the liver. In this large real‐world study, we found that one commonly used beta‐blocker (propranolol) was associated with a higher risk of blood clots in the portal vein, while another (carvedilol) did not increase this risk and was linked to better survival. These findings suggest that the choice of beta‐blocker may significantly affect patient outcomes.