| Equal efficacy of endoscopic variceal ligation and propranolol in preventing variceal bleeding in patients with noncirrhotic portal hypertension. | |
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MedLine Citation:
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PMID: 20547163 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: Variceal bleeding increases morbidity and mortality among patients with noncirrhotic portal hypertension (NCPH). Blockers of β-adrenergic receptor signaling and endoscopic variceal ligation (EVL) have been used to prevent recurrence of bleeding, based on data from cirrhotic patients. We compared the efficacy and safety of the β-blocker propranolol with that of EVL in preventing the recurrence of variceal bleeding in patients with NCPH. METHODS: Consecutive patients with NCPH with a history of variceal bleeding in the past 6 weeks were assigned randomly to groups treated every 3 weeks with EVL (n = 51) or propranolol (until they had a resting heart rate of 55 beats per minute or to a maximum of 320 mg/day; n = 50). Primary end points were recurrence of variceal bleeding or death. Secondary end points were complications of EVL in patients given EVL, variceal eradication after EVL, variceal recurrence after EVL, or a decrease in variceal grade in patients given propranolol. RESULTS: After a median follow-up period of 23 months, rates of recurrence of bleeding were similar between the groups (EVL, 23.5%; propranolol, 18%; P = .625). The actuarial probability of remaining free of bleeding recurrence was similar between the groups. No deaths occurred in either group. Of the patients given propranolol, 47% had a decrease in the grade of varices and none experienced bleeding. Adverse events were minor and comparable between groups (EVL, 12%; propranolol, 18%; P = .635). CONCLUSIONS: EVL was not more effective than the β-blocker propranolol for the secondary prophylaxis of variceal bleeding in patients with NCPH. |
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Authors:
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Shiv Kumar Sarin; Nitin Gupta; Sanjeev Kumar Jha; Amit Agrawal; Smruti Ranjan Mishra; Barjesh Chander Sharma; Ashish Kumar |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2010-06-12 |
Journal Detail:
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Title: Gastroenterology Volume: 139 ISSN: 1528-0012 ISO Abbreviation: Gastroenterology Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-04 Completed Date: 2010-10-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374630 Medline TA: Gastroenterology Country: United States |
Other Details:
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Languages: eng Pagination: 1238-45 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India. shivsarin@gmail.com |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT01000779 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adrenergic beta-Antagonists / therapeutic use* Adult Child Child, Preschool Esophageal and Gastric Varices / therapy* Female Gastrointestinal Hemorrhage / prevention & control* Humans Hypertension, Portal / complications* Ligation Male Propranolol / therapeutic use* Recurrence |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 525-66-6/Propranolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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