Impact of an acute hemodynamic response-guided protocol for primary prophylaxis of variceal bleeding

Table 2 Characteristics of chronic hemodynamic responders and chronic nonresponders in each group

	Traditional NSBB			Carvedilol
Variable1	CR, n = 15	CNR, n = 12	P value	CR, n = 9	CNR, n = 4	P value
Age in yr	58.9 ± 8.3	57.8 ± 10.3	0.766	59.2 ± 9.2	57.3 ± 6.8	0.685
Sex (male)	12 (80.0)	9 (75.0)	1	8 (88.9)	3 (75.0)	1
Body mass index	28.8 ± 2.1	29.1 ± 4.3	0.795	30.5 ± 5.9	28.0 ± 3.6	0.370
Associated diseases2	12 (80.0)	10 (83.3)	1	7 (77.8)	2 (50)	0.530
Regular medication
Statins	2 (13.3)	1 (8.3)	1	2 (22.2)	0 (0)	1
Metformin	3 (20)	2 (16.7)	1	1 (11.1)	2 (50.0)	0.203
Antiplatelet agent	1 (6.7)	3 (25)	0.294	0 (0)	0 (0)	1
Anticoagulation	1 (6.7)	1 (8.3)	1	0 (0)	0 (0)	1
Etiology of liver disease			0.063			1
Alcohol	14 (93.3)	6 (50.0)	0.024	8 (88.9)	4 (100)	1
Hepatitis C	0 (0)	2 (16.7)	0.188	0 (0)	0 (0)	1
Alcohol + hepatitis C	0 (0)	2 (16.7)	0.188	0 (0)	0 (0)	1
Other	1 (6.7)	2 (16.6)	0.569	1 (11.1)	0 (0)	1
Active alcoholism	0 (0)	1 (9.1)	0.440	1 (12.5)	1 (25.0)	1
Active hepatitis C	0 (0)	0 (0)	1	0 (0)	0 (0)	1
Esophageal varices	14 (93.3)	11 (91.7)		6 (66.7)	4 (100)
Small, %	0	0	1	33.3	0	0.467
Large, %	100	100		66.7	100
Gastric varices	1 (6.7)	1 (8.3)	1	3 (33.3)	0 (0.0)	0.497
Red signs	3 (20.0)	1 (8.3)	0.605	1 (12.5)	1 (25.0)	1
Baseline MELD	11.5 ± 2.9	11.0 ± 3.4	0.660	12.3 ± 6.3	12.8 ± 1.0	0.852
Change from baseline, %	-4.1 ± 14.2	0.8 ± 16.8	0.426	-0.8 ± 28.0	-7.9 ± 14.5	0.565
Baseline Child-Pugh score	6.7 ± 1.4	6.1 ± 1.1	0.225	6.8 ± 2.0	7.0 ± 0.0	0.753
Change from baseline, %	-3.0 ± 12.1	0.3 ± 9.9	0.465	-7.2 ± 13.7	0.0 ± 11.6	0.363
Baseline Child-Pugh class A/B/C, %	53/47/0	42/58/0	1	67/11/22	0/100/0	0.010
Change from baseline A/B/C, %	67/33/0	67/33/0	1	67/33/0	75/25/0	0.266
Hemoglobin in g/dL	12.8 ± 2.1	14.0 ± 2.2	0.150	12.8 ± 2.0	14.5 ± 2.7	0.319
Platelet count as × 103/μL	107 ± 35	86 ± 27	0.102	91 ± 32	114 ± 41	0.367
Prothrombin time as INR	1.37 ± 0.18	1.32 ± 0.15	0.498	1.28 ± 0.21	1.35 ± 0.04	0.358
Bilirubin in mg/dL	1.3 ± 0.7	1.6 ± 0.8	0.349	1.57 ± 0.96	1.93 ± 1.19	0.619
Albumin in g/dL	3.5 ± 0.5	3.7 ± 0.4	0.397	3.9 ± 0.4	3.5 ± 0.4	0.080
Creatinine in mg/dL	0.72 ± 0.18	0.78 ± 0.16	0.415	0.71 ± 0.25	0.66 ± 0.05	0.590
Sodium in mEq/L	140 ± 2	140 ± 3	0.342	139 ± 2	139 ± 2	0.638
Ascites	9 (60.0)	6 (50.0)	0.707	5 (55.6)	4 (100)	0.228
Hepatic encephalopathy	4 (26.7)	0 (0)	0.106	0 (0)	1 (25.0)	0.308
SBP	3 (20.0)	0 (0)	0.231	0 (0)	0 (0)	1
Hepatocellular carcinoma	0 (0)	0 (0)	1	0 (0)	0 (0)	1
Hemodynamic variables
Weeks between studies	24.2 ± 12.3	29.1 ± 13.4	0.327	26.2 ± 14.0	31.9 ± 29.4	0.732
Propranolol dose in mg	136 ± 111	165 ± 123	0.677
Nadolol dose in mg	87 ± 47	95 ± 21	0.659
Carvedilol dose in mg				18.8 ± 12.5	14.1 ± 7.9	0.434
FHVP in mmHg	10.0 ± 2.7	11.2 ± 2.4	0.250	11.9 ± 3.9	11.0 ± 2.1	0.583
Change from baseline, %	36.4 ± 62.6	-3.5 ± 30.4	0.054	10.4 ± 31.1	1.8 ± 8.4	0.458
WHVP in mmHg	29.6 ± 2.5	29.0 ± 2.9	0.622	28.5 ± 5.7	31.1 ± 5.1	0.437
Change from baseline, %	-8.5 ± 15.9	0.7 ± 10.6	0.100	-9.5 ± 9.5	5.8 ± 9.2	0.034
HVPG in mmHg	19.5 ± 2.9	17.9 (2.5)	0.126	16.4 ± 2.5	20.1 ± 3.2	0.100
Change from baseline, %	- 26.0 ± 12.5	5.7 ± 17.7	< 0.0001	-21.2 ± 12.8	-7.6 ± 13.3	0.012
Decrease by > 10%	15 (100)	0 (0)	< 0.0001	8 (88.9)	0 (0)	0.007
Decrease < 12 mmHg	3 (20)	0 (0)	0.231	4 (44.0)	0 (0)	0.228
MAP in mmHg	99 ± 9	98 ± 8	0.642	96 ± 12	97 ± 11	0.897
Change from baseline, %	-5.6 ± 7.3	0.3 ± 12.1	0.192	6.6 ± 17.8	-2.0 ± 7.7	0.273
Heart rate as bpm	77 ± 11	77 ± 16	0.902	82 ± 11	76 ± 9	0.311
Change from baseline, %	-26.2 ± 12.5	-19.8 ± 14.9	0.265	-26.8 ± 10.6	-17.1 ± 7.7	0.102
Right atrial pressure in mmHg	6.4 ± 2.1	7.4 ± 2.3	0.264	8.4 ± 5.0	7.0 ± 1.4	0.458
Change from baseline, %	74.2 ± 82.3	24.1 ± 66.5	0.100	35.5 ± 97.2	23.2 ± 27.0	0.733
PAP in mmHg	18.3 ± 4.2	17.9 ± 4.3	0.813	20.1 ± 4.8	17.5 ± 3.1	0.281
Change from baseline, %	35.3 ± 42.8	17.4 ± 27.6	0.222	-4.5 ± 18.7	27.5 ± 43.9	0.242
PWP in mmHg	11.5 ± 3.3	11.8 ± 3.5	0.819	12.8 ± 5.3	12.0 ± 3.2	0.751
Change from baseline, %	50.9 ± 57.5	32.0 ± 61.2	0.417	5.5 ± 37.1	14.8 ± 10.8	0.506

¹Quantitative variables were expressed as mean ± standard deviation and qualitative variables as absolute value (proportion);

²Associated diseases: hypertension, diabetes mellitus, dyslipidemia, coronary artery disease, chronic renal disease. CR: Chronic responder; CNR: Chronic nonresponder; FHVP: Free hepatic venous pressure; HVPG: Hepatic venous pressure gradient; MAP: Mean arterial pressure; PAP: Pulmonary arterial pressure; PWP: Pulmonary wedged pressure; SBP: Spontaneous bacterial peritonitis; WHVP: Wedged hepatic venous pressure.