Baveno VII criteria-guided initiation of non-selective beta blocker in patients with compensated advanced chronic liver disease to reduce hepatic decompensation: an open-label randomised controlled trial

INTERVENTION: Control group:Standard treatment;Carvedilol group:Carvedilol treatment; CONDITION: Compensated advanced chronic liver disease with clinically significant portal hypertension or in the high‐risk grey zone of the Baveno VII criteria, without high‐risk varices. PRIMARY OUTCOME: Composite outcome of newly developed high‐risk varices, hepatic decompensation, or death; SECONDARY OUTCOME: Progression of decompensated liver events;The occurrence of HCC; INCLUSION CRITERIA: 1. Age 18 years or older; 2. Diagnosed with chronic liver disease due to one of the following causes: alcoholic liver disease; chronic hepatitis B; chronic hepatitis C; metabolic dysfunction‐associated fatty liver disease; 3. Classified as high‐risk grey zone or CSPH status based on Baveno VII criteria or ANTICIPATE‐NASH model (for obese MASLD) (for ARLD, CHB, CHC, and non‐obese MASLD), with assessment completed within 6 months prior to randomization: (1) Baveno VII criteria: LSM >= 25 kPa (CSPH); or LSM >= 20–< 25 kPa with platelet count < 150×10^9/L; or LSM >= 15–< 20 kPa with platelet count < 110×10^9/L (high‐risk grey zone); (2) ANTICIPATE‐NASH model: CSPH predicted probability > 90% (CSPH); or predicted probability >= 60%–< 90% (high‐risk grey zone).