Related Experiment Video

Updated: Nov 26, 2025

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
07:10

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

Published on: June 18, 2020

21.9K

Carvedilol is associated with improved survival in patients with cirrhosis: a long-term follow-up study

Hannah R McDowell1, Cher Shiong Chuah1, Dhiraj Tripathi2

  • 1Department of Hepatology, Royal Infirmary of Edinburgh, Edinburgh, UK.

Alimentary Pharmacology & Therapeutics
|December 9, 2020
PubMed

Insights

Carvedilol significantly improved survival in patients with cirrhosis and portal hypertension compared to variceal band ligation. This survival benefit may extend beyond liver-related outcomes, warranting further investigation.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Clinical Trials

Background:

  • Primary prophylaxis for variceal hemorrhage in cirrhosis patients typically involves non-selective beta blockers (NSBB) or variceal band ligation (VBL).
  • Non-selective beta blockers, particularly carvedilol, have shown potential for improving survival rates.

Purpose of the Study:

  • To evaluate and compare long-term mortality rates in patients with cirrhosis and portal hypertension who were previously randomized to receive either carvedilol or VBL for primary prophylaxis of variceal hemorrhage.

Main Methods:

  • Retrospective analysis of 152 patients from a multi-center randomized controlled trial (RCT) conducted between 2000 and 2006.
  • Long-term follow-up (up to 20 years) using electronic records to assess all-cause mortality, liver-related mortality, and decompensation events.
  • Intention-to-treat and per-protocol analyses were performed.

Main Results:

  • Carvedilol demonstrated a significant survival advantage, with a median survival of 7.8 years versus 4.2 years for VBL (P=0.03) in intention-to-treat analysis.
  • This survival benefit was confirmed in the per-protocol analysis (P=0.02).
  • No significant differences were observed between groups for transplant-free survival, liver-related mortality, or decompensation events.

Conclusions:

  • Carvedilol provides a significant survival benefit for patients suffering from cirrhosis and portal hypertension.
  • The observed survival advantage may not be solely attributed to liver-related factors, suggesting broader benefits.
  • Further prospective studies are recommended to validate these findings.
Abstract

More Related Videos

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

10.7K
Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR07:24

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Published on: April 8, 2013

24.6K

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
133
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
197
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
107
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
569
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
131
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
100