Citations 1
Mean Arterial Pressure at Admission Predicts 28-day Mortality in Patients With Severe Alcohol-Associated Hepatitis
Ventura-Cots, Meritxell, Clemente, Ana, Alvarado-Tapias, Edilmar, Ravi, Sujan, Cuyàs, Berta , Tanguy, M, Poca, Maria, Jäger, Marion , Arteel, Gavin E. , Villagrasa, Ares, Aguilar-Amorós, Anna, Argemí, Josepmaria , Abraldes, Juan G., Bosques, Francisco, Brown, R, Garcia-Taso, Guadalupe, Genesca, Juan, Schanbl, Bernd, Mathurin, P., Louvet, Alexander, Lucey, Michael R., Shawcross, Debbie L., Verna, Elisabeth, Dasarathy, S, Tu, Wanzhu, Kamath, Patrick S, Chalasani, Naga P, McClain, Craig J, Szabo, Gyongyi, Tang, Qing, Barton, Bruce, Nagy, Laura E. , Shah, Vijay H, Sanyal, Arun J, Singal, Ashwani K, Soriano, Germà, Rautou, Pierre Emmanuel, Shawcross, Debbie L. , Ventura Cots, Meritxell , Bataller, Ramon A , Shawcross, Debbie Lindsay , Cuyas, Berta , Ventura‐Cots, Meritxell , Alvarado‐Tápias, Edilmar , Ravi, Sujan, Tanguy, Marion , Poca, María , Fernández‐Carrillo, Carlos , Villagrasa, Ares , Abraldeṣ, Juan G. , Genescà, Joan , Mathurin, Philippe , Lucey, Michael R., Gawrieh, Samer , Tu, Wanzhu , Kamath, Patrick S. , Chalasani, Naga , McClain, Craig J. , Tang, Qing , Shah, Vijay H. , Sanyal, Arun J. , Mitchell, Mack , Singal, Ashwani K. , Rautou, Pierre-Emmanuel
Clinical and Translational Gastroenterology | June 4, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
INTRODUCTION: Alcohol-associated hepatitis (AH) is a severe condition with high short-term mortality. Identifying key predictors of poor outcomes is critical for guiding therapeutic strategies. Mean arterial pressure (MAP), a key determinant of tissue perfusion and systemic hemodynamics, may play a pivotal role in prognosis. METHODS: We analyzed a multicenter, prospective cohort of 323 patients hospitalized with AH, with validation in an independent cohort of 290 patients. Survival was evaluated using Kaplan-Meier curves and compared with the log-rank (Mantel-Cox) test. Cox proportional hazards models were used to estimate hazard ratios for mortality, adjusted for Model for end stage liver disease score. Mechanistic insights were explored through assessment of cardiovascular biomarkers. RESULTS: A baseline MAP <80 mm Hg was associated with significantly higher mortality at both 28 days (27.3% vs 8.0%) and 90 days (40.3% vs 15.6%; P < 0.001 for both). This association persisted after adjusting for Model for end stage liver disease score, age, and baseline hepatic encephalopathy. The incidence of infections during follow-up was similar across MAP groups (27.6% vs 22.8%), but acute kidney injury occurred more frequently in the MAP <80 mm Hg group (62% vs 38%, P < 0.001). In the validation cohort, patients with MAP <80 mm Hg also demonstrated significantly lower 28-day transplant-free survival. Although B-type natriuretic peptide and plasma renin levels were altered in patients with AH, they did not correlate with MAP values. DISCUSSION: A baseline MAP <80 mm Hg is an independent predictor of short-term and mid-term mortality in patients with AH. Strategies aimed at restoring hemodynamic stability may improve outcomes in this high-risk population.