Thrombolytic Therapy in Octogenarians with Acute Pulmonary Embolism.

Autor:	Zengin A; Department of Cardiology , University of Health Sciences , Dr. Siyami Ersek Training and Research Hospital , Istambul - Turkey., Karataş MB; Department of Cardiology , University of Health Sciences , Dr. Siyami Ersek Training and Research Hospital , Istambul - Turkey., Çanga Y; Department of Cardiology , University of Health Sciences , Dr. Siyami Ersek Training and Research Hospital , Istambul - Turkey., Güzelburç Ö; Department of Cardiology , University of Health Sciences , Dr. Siyami Ersek Training and Research Hospital , Istambul - Turkey., Yelgeç NS; Department of Cardiology , University of Health Sciences , Dr. Siyami Ersek Training and Research Hospital , Istambul - Turkey., Emre A; Department of Cardiology , University of Health Sciences , Dr. Siyami Ersek Training and Research Hospital , Istambul - Turkey.
Jazyk:	English; Portuguese
Zdroj:	Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2022 Jan; Vol. 118 (1), pp. 68-74.
DOI:	10.36660/abc.20201060
Abstrakt:	Background: Despite the high proportion of octogenarians with acute pulmonary embolism, there is little information indicating the optimal management strategy, mainly therapeutic measures, such as lytic therapy. Objectives: The number of elderly patients diagnosed with acute pulmonary embolism increases constantly. However, the role of thrombolytic treatment is not clearly defined among octogenarians. Our objective is to evaluate the effectiveness of lytic therapy in octogenarian patients diagnosed with pulmonary embolism. Methods: One hundred and forty eight subjects (70.3% women, n=104) aged more than eighty years were included in the study. The patients were divided in two groups: thrombolytic versus non-thrombolytic treatment. In-hospital mortality rates and bleeding events were defined as study outcomes. P-value <0.05 was considered as statistical significance. Results: In-hospital mortality decreased significantly in the thrombolytic group compared to the non-thrombolytic group (10.5% vs. 24.2% p=0.03). Minor bleeding events were more common in the arm that received thrombolytic treatment, but major hemorrhage did not differ between the groups (35.1% vs. 13.2%, p<0.01; 7% vs. 5.5% p=0.71, respectively). High PESI score (OR: 1.03 95%CI; 1.01-1.04 p<0.01), thrombolytic therapy (OR: 0.15 95%CI; 0.01-0.25, p< 0.01) and high troponin levels (OR: 1.20 95%CI; 1.01-1.43, p=0.03) were independently associated with in-hospital mortality rates in the multivariate regression analysis. Conclusion: Thrombolytic therapy was associated with reduced in-hospital mortality at the expense of increased overall bleeding complications in octogenarians.
Databáze:	MEDLINE
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