| Autor: |
Shahrori, Zaid M, Alhuneafat, Laith, Sallam, Sherin, jabri, ahmad, Al-Abdouh, Ahmad, Mhanna, Mohammed, Yousaf, Adnan, Abu omar, Yazan, Nasser, Mohamed Farhan, Siraj, Aisha |
| Zdroj: |
Circulation (Ovid); November 2022, Vol. 146 Issue: Supplement 1 pA13657-A13657, 1p |
| Abstrakt: |
Introduction:In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain whether confirmed by imaging or cardiac biomarkers is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator(tPA) for the management of intermediate-risk PE.Methods:We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Patients on standard systemic anticoagulation without thrombolysis or thrombectomy served as controls. Data analysis was done through SAS® Software (version 9.4; Cary, NC) to compare those that received half-dose tPA with controls and statistical significance was set at a p-value of 0.05.Results:We included 57 patients in our final analysis with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups (Table 1). The thrombolytic cohort was more likely to have a 60/60 sign and a thrombus in transit on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3), however, this was not statistically significant.ConclusionPatients who received half-dose tPA had non-significant higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE. |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
|
