Long-term hemodynamic response of carvedilol and simvastatin in compensated versus decompensated chronic liver disease with portal hypertension

Authors

DOI:

https://doi.org/10.3126/ajms.v15i3.59010

Keywords:

Simvastatin; Carvedilol; Hemodynamic study; Chronic liver disease; Decompensated; Compensated

Abstract

Background: A combination of carvedilol and Simvastatin have recognized their role as rescue therapy for carvedilol non-responders in chronic liver disease (CLD)-associated portal hypertension. However, there are scarce data regarding its role in specific subclasses, and stratification of response according to the computed tomographic perfusion (CTP) score has never been seen before.

Aims and Objective: (1) To compare hemodynamic response and side effects of a combination therapy in decompensated and compensated patients. (2) Stratify the effect of combination therapy according to CTP score.

Materials and Methods: In 102 consecutive patients of CLD with esophageal varices, the hepatic venous pressure gradient was measured at baseline and after 3 months of dose optimization of carvedilol. Simvastatin was added to non-responders and hemodynamics repeated at 1 month of dual therapy. The response of compensated CLD was compared with decompensated patients and was stratified as per the CTP on follow-up.

Results: Overall, out of 43 compensated patients, 21 responded acutely and response increased to 29 (67.44%) at 3 months. While 31 of 59 (52.54%) decompensated patients responded acutely but dose escalation did not increase response significantly after 3 months. The addition of Simvastatin did increase the response, although side effects were more in decompensated group. The addition of Simvastatin also decreased decompensation in the high-risk compensated group and maintained their MELD.Na.

Conclusion: Response in compensated CLD patients was more than in decompensated patients; however, it was statistically insignificant. Attrition was more in patients with CTP >10 due to drug intolerance, side effects, or deaths.

Downloads

Download data is not yet available.
Abstract
135
PDF
173

Downloads

Published

2024-03-01

How to Cite

Nazir, S. ., Wani, Z. A., Ahmad, A. ., Asif Iqbal, & Hussain, A. . (2024). Long-term hemodynamic response of carvedilol and simvastatin in compensated versus decompensated chronic liver disease with portal hypertension. Asian Journal of Medical Sciences, 15(3), 115–121. https://doi.org/10.3126/ajms.v15i3.59010

Issue

Vol. 15 No. 3 (2024)

Section

Original Articles

License

Copyright (c) 2023 Asian Journal of Medical Sciences

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. The journal holds copyright and publishes the work under a Creative Commons CC-BY-NC license that permits use, distribution and reprduction in any medium, provided the original work is properly cited and is not used for commercial purposes. The journal should be recognised as the original publisher of this work.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).