Document Detail


B1 selective adrenoreceptor blockade for the long term management of variceal bleeding. A prospective randomised trial to compare oral metoprolol with injection sclerotherapy in cirrhosis.
MedLine Citation:
PMID:  3884469     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Oral metoprolol, in a dose sufficient to reduce resting pulse rate by 25%, was compared with repeated injection sclerotherapy for the long term management of variceal bleeding. The prospective, randomised study was undertaken in 32 patients with biopsy proven cirrhosis and variceal bleeding who were Grade A or B on a modified Child's classification. In the 15 patients receiving metoprolol, portal pressure showed a mean fall of 3.7 mmHg (17.3 +/- 1.2 to 13.6 +/- 1.2 mmHg, p less than 0.01) after four weeks of continuous therapy, as compared with pretreatment levels. Nine of the 15 patients taking metoprolol had further bleeding (total of 21 episodes) compared with six of 17 in the sclerotherapy group (nine episodes). The risk of bleeding per patient/month of follow up was three times higher in the metoprolol group compared with those treated by sclerotherapy (0.14 and 0.04 respectively, p less than 0.025). Rebleeding in the metoprolol group occurred in six of the patients who had a fall in portal pressure of 10% or more.
Authors:
D Westaby; W M Melia; B R Macdougall; J E Hegarty; A E Gimson; R Williams
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Gut     Volume:  26     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  1985 Apr 
Date Detail:
Created Date:  1985-05-09     Completed Date:  1985-05-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  421-5     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Clinical Trials as Topic
Esophageal and Gastric Varices / etiology,  therapy*
Female
Gastrointestinal Hemorrhage / therapy*
Humans
Liver Cirrhosis / complications*
Male
Metoprolol / therapeutic use*
Middle Aged
Prospective Studies
Random Allocation
Sclerosing Solutions / therapeutic use*
Time Factors
Venous Pressure
Chemical
Reg. No./Substance:
0/Sclerosing Solutions; 37350-58-6/Metoprolol
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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