Carvedilol vs. Propranolol in Second Prophylaxis of Variceal Bleeding

This randomized controlled trial was conducted to evaluate the efficacy and safety of carvedilol versus propranolol, combined with routine endoscopic treatment, in the secondary prophylaxis of variceal bleeding in patients with cirrhosis.

Inclusion Criteria:Between 18 and 80 years old;With liver cirrhosis diagnosed by previous biopsy or by clinical criteria, and analytical image;At least 5 days after index variceal bleeding;Informed consent.Exclusion Criteria:Refusal to participate in the study;Portal hypertension resulting from other causes than liver cirrhosis;More than 42 days after index variceal bleeding;Bleeding from cardiofundal gastric varices;Portal venous thrombosis >50% of the portal vein trunk;Contraindications to beta-blockers (asthma, chronic obstructive pulmonary disease, atrioventricular block, heart failure, bradycardia with HR ≤40 bpm, arteria hypotension with systolic blood pressure <90 mm Hg, peripheral arterial disease, uncontrolled diabetes);Prior NSBB+EVL combined treatment, TIPS implantation or surgical shunt as secondary prophylaxis of variceal bledding;Chronic kidney disease;Pregnancy or lactation;Neoplastic disease.