Fast vs. ultraslow thrombolytic infusion regimens in patients with obstructive mechanical prosthetic valve thrombosis: a pilot randomized clinical trial
| Autor: | Parham Sadeghipour, Sedigheh Saedi, Leila Saneei, Farnaz Rafiee, Siamak Yoosefi, Mozhgan Parsaee, Rashide Siami, Milad Saberi, Hamidreza Pouraliakbar, Behshid Ghadrdoost, Hooman Bakhshandeh, Mohammad Mehdi Peighambari, Melody Farrashi, Bahram Mohebbi, Nasim Naderi, Ahmad Amin, Majid Maleki, Zahra Khajali, Raffaele De Caterina |
|---|---|
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | European Heart Journal - Cardiovascular Pharmacotherapy. 8:668-676 |
| ISSN: | 2055-6845 2055-6837 |
| Popis: | Aims Thrombolysis is an alternative to surgery for mechanical prosthetic valve thrombosis (MPVT). Randomized clinical trials have yet to test the safety and efficacy of a proposed ultraslow thrombolytic infusion regimen. Methods and results This single-centre, open-label, pilot randomized clinical trial randomized adult patients with acute obstructive MPVT to an ultraslow thrombolytic regimen [25 mg of recombinant tissue-type plasminogen activator (rtPA) infused in 25 h] and a fast thrombolytic regimen (50 mg of rtPA infused in 6 h). If thrombolysis failed, a repeated dose of 25 mg of rtPA for 6 h was administered in both groups up to a cumulative dose of 150 mg or the occurrence of a complication. The primary outcome was a complete MPVT resolution (>75% fall in the obstructive gradient by transthoracic echocardiography, Conclusion The ultraslow thrombolytic regimen conferred a high thrombosis resolution rate without major complications. Such findings should be replicated in more adequately powered trials. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|