2020
Ordinal Outcomes Are Superior to Binary Outcomes for Designing and Evaluating Clinical Trials in Compensated Cirrhosis
D’Amico G, Abraldes JG, Rebora P, Valsecchi MG, Garcia‐Tsao G. Ordinal Outcomes Are Superior to Binary Outcomes for Designing and Evaluating Clinical Trials in Compensated Cirrhosis. Hepatology 2020, 72: 1029-1042. PMID: 31837238, PMCID: PMC11090179, DOI: 10.1002/hep.31070.Peer-Reviewed Original ResearchConceptsClinical trialsGrade 1Prevention of decompensationBaseline platelet countDevelopment of varicesSignificant outcome differencesLow baseline riskPrimary therapeutic targetCirrhosis decompensationCompensated cirrhosisInception cohortComposite endpointEsophageal varicesPlatelet countBinary outcomesDisease progressionSignificant treatment effectBaseline riskGrade 3Sample sizeOutcome differencesTherapeutic targetDecompensationGrade 2Larger sample size
2018
Esophageal Varices
Jakab S, Garcia-Tsao G. Esophageal Varices. 2018, 195-208. DOI: 10.1007/978-3-319-98506-0_15.Peer-Reviewed Educational MaterialsVariceal hemorrhageEsophageal varicesComplications of cirrhosisEsophageal variceal hemorrhageScreening/surveillanceSecondary prophylaxisVariceal bleedingLiver diseaseTreatment optionsCurrent recommendationsHigh riskCirrhosisPrevention strategiesVaricesComplicationsHemorrhagePatientsProphylaxisBleedingMortalityDiseaseEVHProgressionSeverity
2017
Primary and secondary prophylaxis of esophageal variceal bleeding
Jangouk P, Garcia-Tsao G. Primary and secondary prophylaxis of esophageal variceal bleeding. Techniques And Innovations In Gastrointestinal Endoscopy 2017, 19: 84-89. DOI: 10.1016/j.tgie.2017.03.004.Peer-Reviewed Educational MaterialsHepatic venous pressure gradientPortal hypertensionVariceal hemorrhageHigh riskComplications of cirrhosisSignificant portal hypertensionVenous pressure gradientDevelopment of varicesEsophageal variceal bleedingIsolated complicationSecondary prophylaxisCompensated cirrhosisDirect complicationsVariceal bleedingClinical decompensationPortal pressureEsophageal varicesCompensated stageChronic conditionsCirrhosisVaricesComplicationsHemorrhageDecompensationPatients
2012
The presence of esophageal varices (EV), but not treatment with beta-blockers, is associated with a poorer survival in patients with cirrhosis and ascites
Zipprich A, Garcia-Tsao G, Seufferlein T, Dollinger M. The presence of esophageal varices (EV), but not treatment with beta-blockers, is associated with a poorer survival in patients with cirrhosis and ascites. Zeitschrift Für Gastroenterologie 2012, 50 DOI: 10.1055/s-0031-1295840.Peer-Reviewed Original Research
2009
Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis
Qamar AA, Grace ND, Groszmann RJ, Garcia–Tsao G, Bosch J, Burroughs AK, Ripoll C, Maurer R, Planas R, Escorsell A, Garcia–Pagan J, Patch D, Matloff DS, Makuch R, Rendon G, Group P. Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis. Clinical Gastroenterology And Hepatology 2009, 7: 689-695. PMID: 19281860, PMCID: PMC4545534, DOI: 10.1016/j.cgh.2009.02.021.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientHematologic indicesCompensated cirrhosisBaseline hepatic venous pressure gradientWhite blood cell countChild-Pugh scorePredictors of deathPrimary end pointVenous pressure gradientDevelopment of varicesKaplan-Meier analysisBlood cell countCombination of leukopeniaBaseline thrombocytopeniaVariceal bleedingClinical decompensationEsophageal varicesPrognostic significanceTransplant surgeryClinical significanceLeukopeniaThrombocytopeniaCirrhosisCell countVarices
2007
A pilot project examining the predicted preferences of patients and physicians in the primary prophylaxis of variceal hemorrhage
Longacre AV, Imaeda A, Garcia‐Tsao G, Fraenkel L. A pilot project examining the predicted preferences of patients and physicians in the primary prophylaxis of variceal hemorrhage. Hepatology 2007, 47: 169-176. PMID: 17935182, PMCID: PMC2674014, DOI: 10.1002/hep.21945.Peer-Reviewed Original ResearchConceptsEndoscopic variceal ligationProcedure-related bleedingVariceal hemorrhagePrimary prophylaxisPreferences of patientsRoute of administrationSexual dysfunctionFirst-line therapyShortness of breathIndividual patient preferencesUntreated patientsEsophageal varicesVariceal ligationPrimary preventionPatient preferencesRisk of fatigueTreatment preferencesProphylaxisSide effectsHemorrhagePatientsBleedingPhysiciansFuture guidelinesHypotension
2004
Treatment of acute variceal bleeding: general management and prevention of infections
Garcia-Tsao G. Treatment of acute variceal bleeding: general management and prevention of infections. 2004, 233-240. DOI: 10.1007/978-94-007-1042-9_25.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsVariceal bleedingCirrhotic patientsPoor outcomePredictive factorsHepatic venous pressure gradientUpper gastrointestinal bleeding episodesActive variceal bleedingEarly recurrent bleedingAcute variceal bleedingVenous pressure gradientGastrointestinal bleeding episodesPrevention of infectionAlcoholic etiologyBleeding episodesGastrointestinal hemorrhageRecurrent bleedingRenal dysfunctionVariceal hemorrhageLiver dysfunctionEsophageal varicesUncontrolled bleedingDiagnostic endoscopyHepatocellular carcinomaBleedingPatients
1997
The portal pressure response to beta-blockade is greater in cirrhotic patients without varices than in those with varices
Escorsell A, Ferayorni L, Bosch J, Garcia-Pagan J, Garcia-Tsao G, Grace N, Rodes J, Groszmann R. The portal pressure response to beta-blockade is greater in cirrhotic patients without varices than in those with varices. Gastroenterology 1997, 112: 2012-2016. PMID: 9178694, DOI: 10.1053/gast.1997.v112.pm9178694.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPortal pressure responseVenous pressure gradientCirrhotic patientsPortal pressurePortal hypertensionDevelopment of varicesSingle oral dosePressure responseSystemic hemodynamicsEsophageal varicesOral doseVaricesPatientsAbstractTextBeneficial effectsHypertensionTimololHgEarly stagesPressure gradientCirrhosisAIMSHemodynamicsDose
1991
Propranolol in the prevention of the first hemorrhage from esophagogastric varices: A multicenter, randomized clinical trial
Conn H, Grace N, Bosch J, Groszmann R, Rodés J, Wright S, Matloff D, Garcia‐Tsao G, Fisher R, Navasa M, Drewniak S, Atterbury C, Bordas J, Lerner E, Bramante C. Propranolol in the prevention of the first hemorrhage from esophagogastric varices: A multicenter, randomized clinical trial. Hepatology 1991, 13: 902-912. PMID: 2029994, DOI: 10.1002/hep.1840130517.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientVenous pressure gradientPlacebo groupPropranolol groupEsophageal varicesVariceal hemorrhageChild class AEffectiveness of propranololFirst variceal hemorrhageInitial variceal hemorrhageCessation of therapyPortal hypertensive gastropathyChild class BDoses of propranololLarge esophageal varicesHepatic vein cathetersBeats/minClass BPlacebo patientsPropranolol patientsAlcoholic cirrhosisHypertensive gastropathyMean followMedian doseLarge varices
1990
Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage
Groszmann R, Bosch J, Grace N, Conn H, Garcia-Tsao G, Navasa M, Alberts J, Rodes J, Fischer R, Bermann M, Rofe S, Patrick M, Lerner E. Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology 1990, 99: 1401-1407. PMID: 2210246, DOI: 10.1016/0016-5085(90)91168-6.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientVenous pressure gradientVariceal hemorrhageEsophageal varicesHemodynamic eventsBaseline valuesHeart rateFirst variceal hemorrhagePropranolol-treated groupPropranolol-treated patientsTrial of propranololAdministration of propranololBeginning of therapyRate of survivalPortal hypertensionVariceal bleedingCirrhotic patientsPharmacological therapyVariceal sizeProtective effectMortality ratePatientsPlaceboPropranololVaricesSurgical treatment of hemorrhage of esophageal varices secondary to thrombosis of the portal vein.
Orozco-Zepeda H, Takahashi T, Angel Mercado M, García-Tsao G, Hernández-Ortiz J. Surgical treatment of hemorrhage of esophageal varices secondary to thrombosis of the portal vein. Revista De Gastroenterología De México 1990, 55: 215-9. PMID: 2091189.Peer-Reviewed Original ResearchConceptsHemorrhagic portal hypertensionSugiura procedurePortal hypertensionAssociated liver diseasePortal vein thrombosisProtein C deficiencyActuarial survivalOperative deathsSurgical treatmentVein thrombosisEsophageal varicesLiver diseaseMean ageSurgical stagePortal veinC deficiencyPatientsHypertensionThrombosisEPVTVaricesHemorrhageCasesYearsDisease