ISSN |
2307-8960 (online) |
Open Access |
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
Copyright |
© The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. |
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Publisher |
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA |
Website |
http://www.wjgnet.com |
Category |
Medicine, Research & Experimental |
Manuscript Type |
Retrospective Cohort Study |
Article Title |
Impact of an acute hemodynamic response-guided protocol for primary prophylaxis of variceal bleeding
|
Manuscript Source |
Unsolicited Manuscript |
All Author List |
José Ignacio Fortea, Ángela Puente, Patricia Ruiz, Iranzu Ezcurra, Javier Vaquero, Antonio Cuadrado, María Teresa Arias-Loste, Joaquín Cabezas, Susana Llerena, Paula Iruzubieta, Carlos Rodríguez-Lope, Patricia Huelin, Fernando Casafont, Emilio Fábrega and Javier Crespo |
ORCID |
|
Funding Agency and Grant Number |
Funding Agency |
Grant Number |
Instituto de Investigación Sanitaria Marqués de Valdecilla |
NVAL17/07 |
Instituto Carlos III |
PI15/01083 |
|
Corresponding Author |
José Ignacio Fortea, MD, PhD, Attending Doctor, Research Scientist, Servicio de Aparato Digestivo, Hospital Universitario Marques de Valdecilla, Av. Valdecilla s/n, Santander 39008, Cantabria, Spain. jifortea@gmail.com |
Key Words |
Gastrointestinal hemorrhage; Propranolol; Carvedilol; Liver cirrhosis; Portal hypertension |
Core Tip |
In patients with cirrhosis treated with traditional nonselective beta-blockers (NSBBs) (i.e. propranolol and nadolol), the lack of acute hemodynamic response to intravenous propranolol has been consistently associated with a higher risk of decompensation and death. More¬over, carvedilol is more effective than traditional NSBB in reducing portal pressure. In the present study, we evaluated for the first time the clinical impact of an acute hemodynamic response-guided protocol for the primary prophylaxis of variceal bleeding in which acute hemodynamic responders were treated with traditional NSBB and acute nonresponders with carvedilol. Im¬portantly, the risk of decompensation and survival were similar in both groups, strongly suggesting that carvedilol improved the long-term outcome of acute nonresponders. |
Publish Date |
2018-11-06 10:20 |
Citation |
Fortea JI, Puente Á, Ruiz P, Ezcurra I, Vaquero J, Cuadrado A, Arias-Loste MT, Cabezas J, Llerena S, Iruzubieta P, Rodríguez-Lope C, Huelin P, Casafont F, Fábrega E, Crespo J. Impact of an acute hemodynamic response-guided protocol for primary prophylaxis of variceal bleeding. World J Clin Cases 2018; 6(13): 611-623 |
URL |
http://www.wjgnet.com/2307-8960/full/v6/i13/611.htm |
DOI |
http://dx.doi.org/10.12998/wjcc.v6.i13.611 |