COMPARISON OF CARVEDILOL VERSUS PROPRANOLOL FOR PREVENTION OF ESOPHAGEAL VARICEAL BLEED IN CIRRHOTIC PATIENTS
Keywords:
Chronic Liver Disease, Carvedilol, Variceal bleed, Prophylaxis, propranololAbstract
Objective: To compare the efficacy of carvedilol versus propranolol for prevention of bleed in esophageal varices in cirrhotic patients.
Material and Methods: Randomized controlled trial was conducted at Medicine Department Post Graduate Medical Institute, Lady Reading Hospital, Peshawar from August 2012 to August 2013. Sample size was taken as 176. Patients were randomized in two groups by opaque sealed envelope method after fulfilling Inclusion Criteria. Patients in group "A" were given Carvedilol (6.25 mg/day) while patients in group "B" were given propranolol (20 mg twice daily). All patients were followed up till the end of 3rd month to determine the efficacy of the drug. Drug was considered effective if there was no variceal bleed till 3 months follow up after start of the drug. Chi square test was applied and P-value of ?0.05 was considered as significant.
Results: Of 176 patients, 88 were in group A and 88 were in group B. One hundred and six (60.2%) were male and 70 (39.8%) were females. Mean age of the whole sample was 49.68 years ± 7.912 SD, with age range from 35 to 60 years. In carvedilol group the drug was effective in 75/88 patients (85.2%) and the proportion of variceal bleed was 14.8 % (13 patients). In propranolol group, the drug was effective in 64/88 patients (72.7%). The efficacy of carvedilol therapy (success rate 85.2%) in term of preventing the variceal bleeding was greater than propranolol therapy (success rate 72.7%) and this difference in efficacy was statically significant with p-value <0.042.
Conclusion: Carvedilol is significantly more effective than propranolol in the prevention of variceal bleeding in cirrhotic patients with esophageal varices.
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