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Current screening guidelines for gastroesophageal varices recommend upper endoscopy in patients with cirrhosis. Although numerous studies have attempted to identify noninvasive markers to predict the presence of varices (Hepatology 2004; 39:30), none of the candidate markers to date have demonstrated adequate sensitivity and specificity. Might changes in platelet count over time be a more useful marker?
To evaluate this possibility, researchers conducted a nested cohort study among 213 cirrhotic patients who were participating in a trial of a nonselective beta-blocker, timolol, for the prevention of varices. Ninety percent of the patients had Child A cirrhosis, and 10% had Child B cirrhosis; all had portal hypertension (hepatic venous pressu…