Abstract | BACKGROUND: METHODS: Sixty-six patients who achieved EV eradication by primary EVL were randomly allocated to a propranolol group (n = 33) or control group (n = 33). The endpoints of the study were EV recurrence and volumetric change of PEV assessed by using endoscopic ultrasonography (EUS) at 3-month intervals for 2 years. RESULTS: The cumulative probability of recurrence at two years was 28% in the propranolol group (n = 9) and 68% in the control group (n = 20) (p = 0.005, log-rank test). Difference of the volumetric change of PEV became significant as early as at the third month [-0.12 (-0.38-0.34) vs. 0.14 (-0.06-0.57), p < 0.001] between the two groups. Regression of PEV was achieved in 20 patients of the propranolol group at a median time of three months (range 3-12 months), and no EV recurrence was found at the end of follow-up for two years. On multivariate analysis, the volumetric change of PEV at the third month and use of propranolol were determinants of EV recurrence. CONCLUSIONS:
Propranolol may reduce both EV recurrence rate and volume of PEV in patients achieving endoscopic eradication. Regression of PEV is a predictor of durable eradication of EV without recurrence in patients using propranolol. EUS is an objective and useful tool to measure PEV and predict recurrence of EV.
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Authors | Wei-Chih Liao, Ping-Hsien Chen, Ming-Chih Hou, Chen-Jung Chang, Chien-Wei Su, Han-Chieh Lin, Fa-Yauh Lee |
Journal | Journal of gastroenterology
(J Gastroenterol)
Vol. 50
Issue 3
Pg. 342-9
(Mar 2015)
ISSN: 1435-5922 [Electronic] Japan |
PMID | 24908097
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Adrenergic beta-Antagonists
- Propranolol
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Topics |
- Adrenergic beta-Antagonists
(adverse effects, therapeutic use)
- Adult
- Aged
- Blood Pressure
(drug effects)
- Endosonography
(methods)
- Esophageal and Gastric Varices
(diagnostic imaging, drug therapy, pathology, surgery)
- Esophagoscopy
(methods)
- Female
- Heart Rate
(drug effects)
- Humans
- Kaplan-Meier Estimate
- Ligation
- Male
- Middle Aged
- Prognosis
- Propranolol
(adverse effects, therapeutic use)
- Recurrence
- Risk Factors
- Treatment Outcome
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