Propranolol, Carvedilol and Rosuvastatin in the Prevention of Variceal Bleeding in Cirrhotic Portal Hypertension

Propranolol, Carvedilol and Rosuvastatin in the Prevention of Recurrent Variceal Haemorrhage in Patients With Cirrhotic Portal Hypertension

Patients with hepatic cirrhosis and previous variceal bleeding will be randomly assigned to use propranolol or carvedilol. After 8 weeks, rosuvastatin or placebo will be blindly added to nonresponders (HVPG measurement > 12mmHg) for another 8 weeks and hemodynamic response will be assessed again.

Surrogate serum markers of portal hypertension will be evaluated and correlated to HVPG values and to its variations.

Inclusion Criteria:

• Hepatic cirrhosis of any etiology
• Previous variceal bleeding
• Endoscopic variceal eradication at least 2 weeks before

Exclusion Criteria:

• Beta blocker or statin contraindications
• Model for End-Stage Liver Disease (MELD) score > 25
• Child-Pugh score > 13
• HVPG ≤ 12 mmHg
• Creatinine clearance < 50 mL/min
• Refractory ascites
• Hepatic encephalopathy stages 3 or 4
• Alcohol use in the last 6 months
• Hepatitis C treatment in the last 6 months
• Changing or initiating a new hepatitis B treatment in the last 6 months
• Malignant neoplasms from any origin except basal cell carcinoma
• HIV infection
• Pregnancy
• Anticoagulation
• Recent or complete portal vein thrombosis