Long-term benefit of thrombolytic therapy in patients with pulmonary embolism
| Autor: | Kevin M. McIntyre, Arthur A. Sasahara, Edward D. Folland, G.V.R.K. Sharma |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Time Factors medicine.drug_class Streptokinase Blood Pressure 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Recurrence medicine.artery Internal medicine medicine Humans Thrombolytic Agent Thrombolytic Therapy 030212 general & internal medicine Urokinase Heparin business.industry Anticoagulant Hemodynamics Middle Aged medicine.disease Urokinase-Type Plasminogen Activator Pulmonary hypertension Surgery Pulmonary embolism Survival Rate medicine.anatomical_structure Pulmonary artery Exercise Test Vascular resistance Cardiology Vascular Resistance Pulmonary Embolism Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | Vascular Medicine. 5:91-95 |
| ISSN: | 1477-0377 1358-863X |
| Popis: | A total of 23 of the 40 patients who had angiographically proven pulmonary embolism and who had initially been randomized to an IV infusion of heparin ( n = 11) or a thrombolytic agent (urokinase or streptokinase, n = 12) were restudied after a mean follow-up of 7.4 years to measure the right-sided pressures and to evaluate their response to exercise during supine bicycle ergometry. Results showed that, at rest, the pulmonary artery (PA) mean pressure and the pulmonary vascular resistance (PVR) were significantly higher in the heparin group compared with the thrombolytic group (22 vs. 17 mmHg, p < 0.05, and 351 vs. 171 dynes s-1 cm-5, p < 0.02, respectively). During exercise both parameters rose to a significantly higher level in the heparin group (from rest to exercise, PA: 22-32 mmHg, p < 0.01; PVR: 351-437 dynes s-1 cm-5, p < 0.01, respectively), but not in the thrombolytic group (rest to exercise, PA: 17-19 mmHg, p = NS; PVR: 171-179 dynes s-1 cm-5, p = NS). It is concluded that thrombolytic therapy preserves the normal hemodynamic response to exercise in the long term and may prevent recurrences of venous thromboembolism and the development of pulmonary hypertension. |
| Databáze: | OpenAIRE |
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