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Letter
Beta-blockers in patients with cirrhosis and ascites: type of beta-blocker matters
  1. Basile Njei1,2,
  2. Thomas R McCarty1,
  3. Guadalupe Garcia-Tsao1
  1. 1 Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA
  2. 2 Investigative Medicine Program, Yale Center of Clinical Investigation, New Haven, Connecticut, USA
  1. Correspondence to Dr Basile Njei, Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, P.O. Box 208019, New Haven, CT 06520-8019, USA; basilenjei{at}gmail.com

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Letter to the Editor:

We read with great interest the article by Leithead et al,1 which showed that non-selective beta-blocker (NSBB) therapy was found to be beneficial for patients with ascites, and associated with reduced waitlist deaths even in those with refractory ascites. The study by Sersté et al2 was the first to suggest that NSBB therapy is associated with an increased mortality in patients with cirrhosis and refractory ascites. This led to the NSBB ‘therapeutic window’ hypothesis that claimed that the window would close once a patient developed refractory ascites.3 However, the issue remains controversial as subsequent publications have shown disparate results. In a recent study by Bossen et al,4 which compiled data from three randomised …

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