2024
A Validated Algorithm to Identify Hepatic Decompensation in the Veterans Health Administration Electronic Health Record System
Haque L, Tate J, Chew M, Caniglia E, Taddei T, Re V. A Validated Algorithm to Identify Hepatic Decompensation in the Veterans Health Administration Electronic Health Record System. Pharmacoepidemiology And Drug Safety 2024, 33: e70024. PMID: 39477692, DOI: 10.1002/pds.70024.Peer-Reviewed Original ResearchConceptsVeterans Health Administration dataHealth administrative dataAdministrative dataElectronic health record systemsHealth record systemsInternational Classification of DiseasesCoding algorithmOutpatient International Classification of DiseasesPositive predictive valueClassification of DiseasesHepatic decompensationDiagnosis codesPharmacoepidemiologic researchMedical recordsVeteransRecording systemValidation algorithmAlgorithmChronic liver diseaseDecompensationLiver diseasePredictive valueRecordsDiagnosisThe Association Between Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Exposure and Key Cirrhosis-Related Outcomes.
Wang R, Serper M, Taddei T, Kaplan D, Mahmud N. The Association Between Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Exposure and Key Cirrhosis-Related Outcomes. The American Journal Of Gastroenterology 2024 PMID: 39051649, DOI: 10.14309/ajg.0000000000002976.Peer-Reviewed Original ResearchAssociated with hepatic decompensationAngiotensin-converting enzyme inhibitorsAssociated with reduced mortalityAngiotensin receptor blockersACE-I/ARBConverting enzyme inhibitorsCV-related mortalityHepatocellular carcinomaHepatic decompensationCox regressionAngiotensin receptor blocker exposureEnzyme inhibitorsVeterans Health AdministrationCalcium channel blockersSubsets of patientsChronic liver diseaseCause-specific hazard modelInverse probability treatmentIdentified new initiatorsOutcome of mortalityNew initiativesCirrhosis decompensationCompensated cirrhosisDecompensated cirrhosisChannel blockers
2022
Nonselective beta blockers, hepatic decompensation, and mortality in cirrhosis: A national cohort study
Serper M, Kaplan DE, Taddei TH, Tapper EB, Cohen JB, Mahmud N. Nonselective beta blockers, hepatic decompensation, and mortality in cirrhosis: A national cohort study. Hepatology 2022, 77: 489-500. PMID: 35984731, PMCID: PMC9877112, DOI: 10.1002/hep.32737.Peer-Reviewed Original ResearchConceptsNonselective beta blockersSelective beta blockersLiver-related mortalityHepatic decompensationBeta blockersCTP classPlatelet countSubgroup analysisLiver disease etiologyLower hazardNational cohort studyNew-user designInverse probability treatmentRoutine clinical settingPrior decompensationViremia statusChild-TurcotteHCV viremiaClinical confoundersComposite outcomeCohort studyPrimary outcomeActive comparatorNational cohortDecompensation
2021
Impact of Obeticholic acid Exposure on Decompensation and Mortality in Primary Biliary Cholangitis and Cirrhosis
John BV, Schwartz K, Levy C, Dahman B, Deng Y, Martin P, Taddei TH, Kaplan DE. Impact of Obeticholic acid Exposure on Decompensation and Mortality in Primary Biliary Cholangitis and Cirrhosis. Hepatology Communications 2021, 5: 1426-1436. PMID: 34430786, PMCID: PMC8369937, DOI: 10.1002/hep4.1720.Peer-Reviewed Original ResearchPrimary biliary cholangitisLiver-related mortalityHepatic decompensationOCA useOCA usersPBC cirrhosisObeticholic acidPropensity score modelBiliary cholangitisScore modelRetrospective cohort studySerious liver injuryTreatment of patientsEffect of treatmentCohort studyPartial respondersLiver injuryMultivariable analysisPotential confoundersC-statisticUS veteransUrsodeoxycholic acidBaseline riskCirrhosisDecompensationProtease inhibitor-based direct-acting antivirals are associated with increased risk of aminotransferase elevations but not hepatic dysfunction or decompensation
Torgersen J, Newcomb CW, Carbonari DM, Rentsch CT, Park LS, Mezochow A, Mehta RL, Buchwalder L, Tate JP, Bräu N, Bhattacharya D, Lim JK, Taddei TH, Justice AC, Lo Re V. Protease inhibitor-based direct-acting antivirals are associated with increased risk of aminotransferase elevations but not hepatic dysfunction or decompensation. Journal Of Hepatology 2021, 75: 1312-1322. PMID: 34333102, PMCID: PMC8604762, DOI: 10.1016/j.jhep.2021.07.021.Peer-Reviewed Original ResearchConceptsSevere hepatic dysfunctionBaseline FIB-4Acute liver injuryHepatic dysfunctionInhibitor-based treatmentHepatic decompensationFIB-4Liver injuryHigh riskDAA therapyHazard ratioAdvanced liver fibrosis/cirrhosisRisk of ALIProtease inhibitor-based regimensProtease inhibitor-based treatmentLiver fibrosis/cirrhosisInhibitor-based regimensHepatitis C infectionSevere liver dysfunctionFibrosis/cirrhosisInhibitor-based therapyAminotransferase elevationChronic HCVALT elevationC infectionUrsodeoxycholic Acid Response Is Associated With Reduced Mortality in Primary Biliary Cholangitis With Compensated Cirrhosis
John BV, Khakoo NS, Schwartz KB, Aitchenson G, Levy C, Dahman B, Deng Y, Goldberg DS, Martin P, Kaplan DE, Taddei TH. Ursodeoxycholic Acid Response Is Associated With Reduced Mortality in Primary Biliary Cholangitis With Compensated Cirrhosis. The American Journal Of Gastroenterology 2021, 116: 1913-1923. PMID: 33989225, PMCID: PMC8410631, DOI: 10.14309/ajg.0000000000001280.Peer-Reviewed Original ResearchConceptsLiver-related deathPrimary biliary cholangitisUDCA responseHepatic decompensationHepatocellular carcinomaUrsodeoxycholic acidUDCA respondersPortal hypertensionPartial respondersBiliary cholangitisTime-updated Cox proportional hazards modelsCox proportional hazards modelUrsodeoxycholic acid responseLiver-related mortalityRetrospective cohort studyProportional hazards modelPBC cirrhosisCompensated cirrhosisCohort studyMale patientsClinical benefitUnadjusted ratesCirrhosisReduced mortalityDecompensationSACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation
Kaplan D, Mehta R, Garcia-Tsao G, Albrecht J, Aytaman A, Baffy G, Bajaj J, Hernaez R, Hunt K, Ioannou G, Johnson K, Kanwal F, Lee T, Monto A, Pandya P, Schaubel D, Taddei T. SACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation. Contemporary Clinical Trials 2021, 104: 106367. PMID: 33771685, PMCID: PMC8422958, DOI: 10.1016/j.cct.2021.106367.Peer-Reviewed Original ResearchConceptsHepatic decompensationPortal hypertensionEvents of decompensationHepatic decompensation eventsLiver-related deathSignificant portal hypertensionAcceptable safety profileProspective human studiesRole of statinsChronic liver diseaseClasses of medicationsPatient-reported outcomesDevelopment of decompensationEffect of simvastatinVA Medical CenterCompensated cirrhosisDecompensation eventsStatin therapyVariceal hemorrhageCirrhotic patientsStandard therapyVascular reactivityExert pleiotropic effectsLiver diseaseRetrospective studyMortality and Hepatic Decompensation in Patients With Cirrhosis and Atrial Fibrillation Treated With Anticoagulation
Serper M, Weinberg EM, Cohen JB, Reese PP, Taddei TH, Kaplan DE. Mortality and Hepatic Decompensation in Patients With Cirrhosis and Atrial Fibrillation Treated With Anticoagulation. Hepatology 2021, 73: 219-232. PMID: 32267547, PMCID: PMC7541418, DOI: 10.1002/hep.31264.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsEffect of anticoagulationAtrial fibrillationCause mortalityMarginal structural modelsHepatic decompensationIschemic strokeMajor adverse cardiovascular eventsAdvanced liver diseaseAdverse cardiovascular eventsIncident atrial fibrillationSplanchnic vein thrombosisPropensity-score matchingCardiovascular eventsOral anticoagulantsVein thrombosisFinal cohortLiver diseaseTime-dependent confoundingAnticoagulationLower incidenceMedical CenterCirrhosisWarfarinU.S. veterans
2020
Effects of Metformin Exposure on Survival in a Large National Cohort of Patients With Diabetes and Cirrhosis
Kaplan DE, Serper M, John BV, Tessiatore KM, Lerer R, Mehta R, Fox R, Aytaman A, Baytarian M, Hunt K, Albrecht J, Taddei TH, Group V. Effects of Metformin Exposure on Survival in a Large National Cohort of Patients With Diabetes and Cirrhosis. Clinical Gastroenterology And Hepatology 2020, 19: 2148-2160.e14. PMID: 32798709, DOI: 10.1016/j.cgh.2020.08.026.Peer-Reviewed Original ResearchConceptsDiagnosis of cirrhosisEnzyme inhibitors/angiotensinMetformin exposureHepatic decompensationHepatocellular carcinomaDiabetes mellitusPrognosis of cirrhosisPropensity-matched approachPre-existing diabetesRetrospective cohort studyLarge national cohortVeterans Health AdministrationMarginal structural modelsConcomitant statinCohort studyMultiple medicationsStatin exposureNational cohortCirrhosisPatientsDiabetesDecompensationMetforminConcomitant exposureHealth Administration
2019
Effects of Hypercholesterolemia and Statin Exposure on Survival in a Large National Cohort of Patients With Cirrhosis
Kaplan DE, Serper M, Mehta R, Fox R, John B, Aytaman A, Baytarian M, Hunt K, Albrecht J, Njei B, Taddei TH, Group V. Effects of Hypercholesterolemia and Statin Exposure on Survival in a Large National Cohort of Patients With Cirrhosis. Gastroenterology 2019, 156: 1693-1706.e12. PMID: 30660733, DOI: 10.1053/j.gastro.2019.01.026.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, HepatocellularCholesterolFemaleHeart FailureHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaLiver CirrhosisLiver NeoplasmsMaleMiddle AgedMyocardial InfarctionPropensity ScoreProportional Hazards ModelsRandomized Controlled Trials as TopicRetrospective StudiesStrokeSurvival RateUnited StatesConceptsRetrospective cohort studyStatin exposureLarge national cohortHepatic decompensationStatin useCohort studyHazard ratioNational cohortMultivariable Cox proportional hazards modelsCox proportional hazards modelBaseline total cholesterolPrior statin exposureStatin-naïve subjectsEffect of hypercholesterolemiaVeterans Health AdministrationProportional hazards modelHepatocellular carcinoma developmentDecrease of mortalityRisk-set matchingChild-TurcottePugh classStatin therapyDL increaseTotal cholesterolHepatic function
2017
Comparing Child-Pugh, MELD, and FIB-4 to Predict Clinical Outcomes in Hepatitis C Virus-Infected Persons: Results From ERCHIVES
Butt AA, Ren Y, Re V, Taddei T, Kaplan DE. Comparing Child-Pugh, MELD, and FIB-4 to Predict Clinical Outcomes in Hepatitis C Virus-Infected Persons: Results From ERCHIVES. Clinical Infectious Diseases 2017, 65: 64-72. PMID: 28369305, DOI: 10.1093/cid/cix224.Peer-Reviewed Original ResearchConceptsHCV-positive personsHepatic decompensationFIB-4 scoreHuman immunodeficiency virusFIB-4Hepatocellular carcinomaCause mortalityLower riskHCV diagnosisClinical outcomesHepatitis C virus-infected personsHepatitis B surface antigenCohort of HCVVirus-infected personsB surface antigenHepatitis C virusChild-TurcotteChild-PughEarly complicationsMELD scoreImmunodeficiency virusC virusIncidence ratePositive personsTreatment decisions