ArticleDigestive diseases and sciences2026
Comparative Risk of Recurrent Esophageal Variceal Hemorrhage and Other Decompensation Events with Carvedilol Versus Propranolol in Patients with Cirrhosis: A Retrospective Study.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Continuation Versus Discontinuation of Nonselective Beta-Blockers After Transjugular Intrahepatic Portosystemic Shunt Placement: A Real-World, Target-Trial Emulation Analysis.Journal of clinical medicine · 2026Article
- Preventing First and Further Decompensation in Advanced Chronic Liver Disease.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Hypertension associated with systemic therapy for hepatocellular carcinoma and management strategies.Frontiers in pharmacology · 2026Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsNon-selective beta-blockers (NSBBs) have become a cornerstone treatment to prevent complications of cirrhosis and portal hypertension. Data supporting the use of a specific beta-blocker are scarce. In this retrospective study, we aimed to compare the effectiveness of carvedilol versus propranolol in: 1) preventing recurrent esophageal hemorrhage (EVH) in patients with prior history of EVH 2) reducing the occurrence of further decompensation episodes in these patients including hepatic encephalopathy (HE), ascites, spontaneous bacterial peritonitis (SBP), hepatorenal syndrome (HRS), and hepatocellular carcinoma (HCC), and 3) reducing all-cause mortality. APPROACH &
resultsThis was a retrospective propensity-matched study using the multi-institutional database TriNetX. We included patients with cirrhosis who had an episode of EVH and were prescribed carvedilol or propranolol between December 2004 and December 2024. The primary outcome was the rate of hospitalization with recurrent EVH within the first 5 years of starting the index NSBB. The secondary outcomes were hospitalization with the principal diagnoses of ascites, SBP, HE, HRS, new diagnosis of HCC, undergoing liver transplant (LT), and all-cause mortality within the observation period of 5 years of NSBB prescription. Kaplan-Meier survival analysis was also performed. Compared to propranolol use, carvedilol use was associated with lower risk of EVH (RR, 0.898, P < 0.001), ascites (RR, 0.757, P < 0.001), SBP (RR, 0.680, P < 0.001), HRS (RR, 0.734, P < 0.001), HCC (RR, 0.701, P < 0.001), undergoing LT (RR, 0.825, P = 0.028) and mortality (RR, 0.640, P < 0.001). No difference in HE rates (RR, 0.899, P = 0.071) was found between the two groups.
conclusionsCompared to propranolol, the use of carvedilol in patients with history of cirrhosis and EVH was associated with lower risk of recurrent EVH, further decompensation episodes, undergoing LT, and mortality.
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