Original ArticleHemodynamic Response to Carvedilol is Maintained for Long Periods and Leads to Better Clinical Outcome in Cirrhosis: A Prospective Study
Section snippets
Patients
This was a prospective study conducted in the Department of Gastroenterology at Sir Ganga Ram Hospital, New Delhi, India, between August 2011 and May 2013. The ethics committee of the hospital approved the study and a written informed consent was obtained from all the participants. The study conformed to the Helsinki declaration of 1975 as revised in 1983.
Patients
Between August 2011 and December 2012, a total of 80 patients, in whom NSBB was indicated, were enrolled for the study. Eleven patients were excluded for following reasons: (i) Already on NSBBs at the time of HVPG (n = 6); (ii) grade 3–4 hepatic encephalopathy at the time of enrollment (n = 3); and (iii) systolic blood pressure <90 mm Hg at the time of HVPG (n = 2). Hence, remaining 69 patients were included in the study. The last included patient was followed till May 2013.
The baseline
Discussion
To summarize the results, our study showed that before beginning carvedilol therapy, acute hemodynamic response testing is a reliable method of predicting which patients are more likely to respond to carvedilol in long-term. In our study, the acute-hemodynamic-response was seen in 67% of patients and most (92%) of these acute responders maintained their response to carvedilol over long-term (6 months). In addition, carvedilol therapy led to better clinical outcome in these patients compared to
Authors’ Contribution
Study design, supervision – AA, AK, PS.
Patient enrollment, data collection – VK, VG, MG, RC.
Data analysis, statistics – AK.
Drafting of manuscript – VK, AK.
Critical revision for important intellectual content – PS, VS, NB.
Conflicts of Interest
The authors have none to declare.
Acknowledgements
This study did not receive any external funding.
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