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Hemodynamic effects of propranolol with spironolactone in patients with variceal bleeds: A randomized controlled trial.

Author(s): De BK, Dutta D, Som R, Biswas PK, Pal SK, Biswas A

Affiliation(s): Department of Medicine, Medical College, 64/4A/1A Dr. Suresh Chandra Banerjee Road, Calcutta 700010, India. binaykde@hotmail.com.

Publication date & source: 2008-03-28, World J Gastroenterol., 14(12):1908-13.

AIM: To study the hemodynamic effects of spironolactone with propranolol vs propranolol alone in the secondary prophylaxis of variceal bleeding. METHODS: Thirty-five cirrhotics with variceal bleeding randomly received propranolol (n = 17: Group A) or spironolactone plus propranolol (n = 18: Group B). Hemodynamic assessment was performed at baseline and on the eighth day. RESULTS: Spironolactone with propranolol caused a greater reduction in the hepatic venous pressure gradient than propranolol alone (26.94% vs 10.2%; P < 0.01). Fourteen out of eighteen patients on the combination treatment had a reduction in hepatic venous pressure gradient to <= 12 mmHg or a 20% reduction from baseline in contrast to only six out of seventeen (6/17) on propranolol alone (P < 0.05). CONCLUSION: Spironolactone with propranolol results in a better response with a greater reduction in hepatic venous pressure gradient in the secondary prophylaxis of variceal bleeding. A greater number of patients may be protected by this combination therapy than by propranolol alone. Hence, this combination may be recommended for secondary prophylaxis in patients with variceal bleeding.

Page last updated: 2008-03-26

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