{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T10:18:44Z","timestamp":1784801924859,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T00:00:00Z","timestamp":1607472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary prophylaxis of variceal haemorrhage with non\u2010selective beta blockers (NSBB) or variceal band ligation (VBL) is now standard of care in patients with cirrhosis with portal hypertension. NSBB, and particularly carvedilol, may be associated with improved survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess mortality in a cohort of patients previously randomised to either carvedilol or VBL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed 152 patients recruited to a multi\u2010centre randomised controlled trial between 7 April 2000 and 24 June 2006 designed to assess the efficacy of VBL versus carvedilol in preventing first variceal bleed. We used electronic records to undertake long\u2010term follow\u2010up (up to 20\u00a0years) with the primary outcome of all\u2010cause mortality and secondary end points of liver\u2010related mortality and decompensation events (ascites, encephalopathy, variceal bleeding).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 152 patients in analysis with baseline characteristics well matched between the carvedilol (n\u00a0=\u00a077) and VBL (n\u00a0=\u00a075) groups. In the intention\u2010to\u2010treat analysis, carvedilol offered a significant survival advantage with median survival of 7.8\u00a0years compared to 4.2\u00a0years in the VBL group (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). This survival benefit was maintained in per\u2010protocol analysis when patients who crossed between treatment arms were excluded (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Transplant\u2010free survival, liver\u2010related mortality and decompensation events were similar in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data suggest that carvedilol offers a significant survival benefit for patients with cirrhosis and portal hypertension. The difference in all\u2010cause and liver\u2010related mortality suggests that this survival benefit may not be entirely liver\u2010related. Prospective, studies are required to confirm these important findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16189","type":"journal-article","created":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T05:35:30Z","timestamp":1693719330000},"page":"531-539","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Carvedilol is associated with improved survival in patients with cirrhosis: a long\u2010term follow\u2010up study"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8790-5395","authenticated-orcid":false,"given":"Hannah R.","family":"McDowell","sequence":"first","affiliation":[{"name":"Department of Hepatology Royal Infirmary of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5936-3370","authenticated-orcid":false,"given":"Cher Shiong","family":"Chuah","sequence":"additional","affiliation":[{"name":"Department of Hepatology Royal Infirmary of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Liver Unit Queen Elizabeth Hospital Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian J.","family":"Stanley","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Glasgow Royal Infirmary Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7293-2574","authenticated-orcid":false,"given":"Ewan H.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Glasgow Royal Infirmary Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Hepatology Royal Infirmary of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2019.12.001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.11.019"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)31562-5"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(96)80296-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80108-1"},{"key":"e_1_2_8_7_1","first-page":"20","article-title":"Beta\u2010blockers in liver cirrhosis","volume":"27","author":"Giannelli V","year":"2014","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23689"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300124"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.40179.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840360612"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-304038"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22358"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23775"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.01.034"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31875-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306502"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23045"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/147323000503300508"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.18.2227"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2012.04.012"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.11.031"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000035653.72855.BF"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2019.00202"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i47.8263"}],"container-title":["Alimentary Pharmacology &amp; 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