Tariq Ahmad, Ayesha Athar, Naeem Sarwar, Rana Shakil Ahmad.
Impact of Carvedilol Versus Carvedilol Plus Simvastatin on Cirrhotic Patients Presenting with Variceal Bleeding.
Ann Pak Inst Med Sci Jan ;13(2):191-4.

Objective: To compare the frequency of rebleeding and mortality in carvedilol versus carvedilol plus simvastatin in cirrhotic patients presenting with variceal bleeding. Study Design: Randomized Clinical Trial. Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital, Lahore, from August 2016 to February 2017 Methodology: One hundred and ninety patients were in included in this study after careful consideration of criteria. Patients of either gender or any age with cirrhosis were included in this study from Department of Gastroenterology, Shaikh Zayed Hospital, Lahore after taking informed consent. The patients were randomly divided into two groups by using lottery method. In group A, patients were given carvedilol alone with standard treatment for cirrhosis. In group B, the patient was given carvedilol plus simvastatin and standard treatment of cirrhosis. Treatment was started on 6th day of index bleed. Dose of carvedilol was 6.25mg/dl with subsequent increase to12.5mg/dl at day 15 if the initial dose was tolerated. All patients were followed up till 8 months in OPD, rebleeding was evaluated for rebleeding. Data was analyzed using SPSS 20. Inc. Results: The mean age of the study samples was 40.47 with a standard deviation of 8.74 years. 106(55.8%) were male cases. Mean duration of cirrhosis was 2.56±0.93 years at the time of presentation. A significant difference was observed with respect to mortality and rebleeding in carvedilol versus carvedilol plus simvastatin treatment group (p-value<0.05). Conclusion: Combination therapy is good for controlling rebleeding and mortality as compared to single therapy alone.

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