Document Detail


Beta-blockade prevents recurrent gastrointestinal bleeding in well-compensated patients with alcoholic cirrhosis: a multicenter randomized controlled trial.
MedLine Citation:
PMID:  2563985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the efficacy of beta-blockers in preventing rebleeding in selected cirrhotic patients and to compare the tolerance, safety and patient compliance of a selective and a nonselective beta-blocker, 94 patients were randomly assigned to propranolol (32 patients), atenolol (32 patients) or placebo (30 patients). Randomization was made at least 15 days after the bleeding episode. Propranolol was given orally at increasing doses until the resting pulse rate was reduced by approximately 25%. Atenolol was given at a fixed dose of 100 mg per day. Patients were followed up for a mean of 357 days. Rebleeding occurred in 14 patients in the placebo group, 10 in the atenolol group and eight in the propranolol group. The incidence of rebleeding was significantly lower in patients receiving propranolol than in those on placebo (propranolol vs. placebo: p = 0.01, logrank test). Atenolol was less effective than propranolol (atenolol vs. placebo: p = 0.065, logrank test). Bleeding-free survival was better for patients on active drugs than for those on placebo (propranolol vs. placebo = p = 0.01, atenolol vs. placebo: p = 0.05, logrank test). Retrospective analysis revealed that, whatever the type of treatment, abstinence from alcohol was crucial in preventing rebleeding. We conclude that beta-blocker treatment is effective in preventing rebleeding from esophageal varices in carefully selected alcoholic cirrhotic patients who survive at least 2 weeks after acute variceal hemorrhage and stop drinking.
Authors:
M Colombo; R de Franchis; M Tommasini; A Sangiovanni; N Dioguardi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  9     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-04-12     Completed Date:  1989-04-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  433-8     Citation Subset:  IM    
Affiliation:
Institute of Internal Medicine, University of Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adrenergic beta-Antagonists / therapeutic use*
Aged
Alcohol Drinking
Atenolol / therapeutic use*
Clinical Trials as Topic
Esophageal and Gastric Varices / complications
Gastrointestinal Hemorrhage / etiology,  mortality,  prevention & control*
Humans
Liver Cirrhosis, Alcoholic / complications*
Propranolol / therapeutic use*
Random Allocation
Recurrence
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 29122-68-7/Atenolol; 525-66-6/Propranolol

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


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