Clinical efficacy of low dose recombinant tissue-type plasminogen activator for the treatment of acute intermediate-risk pulmonary embolism
| Autor: | Wei-Ling Huang, Hong-Fang Lu, Zhu Jin, Ting-Ting Zhang, Guang-Ming Xiang, Ling-Yun Zhang, Baoan Gao, Zheng Gong, Cheng Lu, Yuan Gong, Yong-Quan Wang |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Systole medicine.medical_treatment Hemodynamics lcsh:Medicine 030204 cardiovascular system & hematology Low dose thrombolysis Recombinant tissue-type plasminogen activator Pulmonary Artery 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents medicine.artery Internal medicine medicine Humans Decompensation Arterial Pressure 030212 general & internal medicine Aged business.industry lcsh:R Anticoagulants General Medicine Thrombolysis Heparin Low-Molecular-Weight Middle Aged medicine.disease Recombinant Proteins Pulmonary embolism Blood pressure Tissue Plasminogen Activator Pulmonary artery Acute Disease Cardiology Female Original Article Intermediate-risk business Pulmonary Embolism Plasminogen activator |
| Zdroj: | Saudi Medical Journal Saudi Medical Journal, Vol 3, Iss 11, Pp 1090-1095 (2018) |
| ISSN: | 0379-5284 |
| Popis: | Objectives: To investigate the efficacy and safety of initial thrombolysis by recombinant tissue-type plasminogen activator (rt-PA) in compared with anticoagulant therapy in patients with acute intermediate-risk pulmonary embolism (PE). Methods : Sixty-six patients with acute intermediate-risk PE were randomly assigned to receive rt-PA or LMWH between June 2014 and June 2017 in our department. We obtained information regarding the difference in the right ventricle/left ventricle (RV/LV) ratio, pulmonary artery systolic pressure (PASP), clinical symptoms improvement, PE-related mortality, hemodynamic decompensation, recurrent PE, and major and minor bleeding. Results : In the rt-PA group, the mean PASP was reduced from 52.0±12.2 at baseline to 34.8±9.4 ( p less than 0.001) and the mean RV/LV ratio was reduced from 1.26±0.22 at baseline to 0.96±0.18 ( p less than 0.001) at 24 hours. In the LMWH group, the mean PASP was 53.4±12.8 at baseline and 48.5±11.9 at 24 hours ( p =0.11), and the mean RV/LV ratio was 1.22±0.19 at baseline and 1.17±0.21 at 24 hours ( p =0.31). In comparison with the LMWH group, there was a significant reduction in PASP and an improvement in the symptom severity in the rt-PA group. At 90 days, there was no difference in mortality, recurrent venous thromboembolism and major bleeding as a safety outcome, but increased minor bleeding and decreased hemodynamic decompensation occurred in the rt-PA group. Conclusions : In patients with acute intermediate-risk PE, low dose thrombolytic therapy is considered safe and effective, it can be recommended as an alternative option in clinical treatment. |
| Databáze: | OpenAIRE |
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