- Gastric variceal hemorrhage carries a particularly poor prognosis, with mortality rates approaching 45% within 3 years and rebleeding rates as high as 35% to 90% despite intervention.
- Use of nonselective beta-blockers (NSBBs) was associated with a significant reduction in overall mortality despite no clear impact on variceal bleeding rates.
- Nadolol conferred the greatest survival advantage; propranolol showed moderate benefit; carvedilol’s role remains unclear.
- Benefits likely extend beyond variceal bleed prevention, potentially linked to reduced bacterial translocation and prevention of decompensation.
- NSBBs may be underutilized in patients with gastric varices and could represent an important adjunct to current interventional strategies.
Source: Gastro Hep Advances
