title: Reduction in early recurrence of variceal bleeding by propranolol.
abstract: Survival after variceal bleeding depends greatly on the outcome of the immediate posthaemorrhagic period. This may in turn depend on the recurrence of bleeding. We therefore prospectively evaluated the influence of propranolol on the recurrence of variceal haemorrhage during the early period after the acute bleeding episode. Twenty consecutive patients with acute variceal haemorrhage and liver disease were randomly assigned to treatment either with propranolol or placebo orally for 14 days. Propranolol significantly decreased the rate of recurrence of variceal haemorrhage during this early period (p = 0.0028; 95% confidence interval in the placebo group, 90 +/- 20%; in the beta blocker group, 20 +/- 26%). Whereas a recurrence of variceal bleeding occurred in 9 of 10 patients in the placebo group, only 2 of 10 rebled during treatment with propranolol. These results suggest that propranolol may prevent rebleeding in the crucial early period after acute haemorrhage from oesophageal varices.
authors.affiliation: Dept. of Internal Medicine, University of Basle, Switzerland.
authors.forename: U A
authors.initials: UA
authors.lastname: Marbet
authors.forename: A
authors.initials: A
authors.lastname: Straumann
authors.forename: K E
authors.initials: KE
authors.lastname: Gyr
authors.forename: C
authors.initials: C
authors.lastname: Beglinger
authors.forename: N
authors.initials: N
authors.lastname: Schaub
authors.forename: J
authors.initials: J
authors.lastname: Bögtlin
authors.forename: J
authors.initials: J
authors.lastname: Loosli
authors.forename: W
authors.initials: W
authors.lastname: Kiowski
authors.forename: R
authors.initials: R
authors.lastname: Ritz
authors.forename: G A
authors.initials: GA
authors.lastname: Stalder
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D004932:Esophageal and Gastric Varices / Q000188:drug therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011433:Propranolol / Q000627:therapeutic use*; D011446:Prospective Studies; D011897:Random Allocation; D012008:Recurrence
chemical_list: D011433:Propranolol