Carvedilol vs. Propranolol for Preventing Rebleeding After Endoscopic Treatment of Cirrhotic Varices

Exclusion Criteria

• •Non-cirrhotic portal hypertension (eg:Budd-Chiari syndrome, extrahepatic portal vein obstruction, idiopathic portal hypertension)
• •Contraindications to non-selective beta-blockers (NSBBs) (eg:asthma, insulin-dependent diabetes mellitus, peripheral vascular disease)
• •Malignant tumors (including hepatocellular carcinoma) or other life-shortening diseases (expected survival\<1 year), including severe cardio-cerebrovascular diseases (eg:severe heart failure, bedridden status after cerebral infarction, cerebral hemorrhage), end-stage renal disease (requiring dialysis), severe pulmonary diseases (eg:acute exacerbation of chronic obstructive pulmonary disease, pulmonary fibrosis)etc
• •Previous shunt or devascularization surgery, oral NSBBs, and/or endoscopic treatment for preventing recurrent variceal bleeding
• •Pregnant or lactating women (female subjects must undergo a pregnancy test before enrollment; positive cases are excluded; lactating women can only enroll after stopping breastfeeding)
• •Allergies to carvedilol, propranolol, or endoscopic treatment-related drugs (eg:local anesthetics, tissue adhesives)
• •Severe hepatic and renal insufficiency: Child-Pugh class C with a score \> 12, or MELD score \> 30; serum creatinine \> 221 μmol/L (2.5 mg/dl) with estimated glomerular filtration rate (eGFR) \< 30 ml/(min·1.73m²)
• •Severe coagulation disorders: prothrombin time (PT) prolonged by \> 10 seconds, or international normalized ratio (INR) \> 2.5 without effective correction measures