Fibrinolysis for patients with intermediate-risk pulmonary embolism
| Autor: | Sebastian Schellong, Mustapha Sebbane, Thierry Danays, Samuel Z. Goldhaber, Guy Meyer, Irene M. Lang, Cecilia Becattini, Eric Vicaut, Francis Couturaud, Christian Kupatt, Bożena Sobkowicz, Adam Torbicki, Claudia Dellas, Franck Verschuren, Erich Bluhmki, Hélène Bouvaist, Abstr Act, Nicolas Meneveau, Branislav Stefanovic, Benjamin Brenner, Annette Geibel, Piotr Pruszczyk, Mareike Lankeit, Jan Beyer-Westendorf, Ana Franca, Nils Kucher, Klaus Empen, David Jiménez, Matija Kozak, Nazzareno Galiè, Holger Thiele, Antoniu Petris, Giancarlo Agnelli, Gerard Pacouret, Aldo Salvi, Stavros Konstantinides, Matteo Rugolotto, Massimiliano Palazzini |
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| Přispěvatelé: | Hôpital Européen Georges Pompidou [APHP] ( HEGP ), GIRC Thrombose, Service de Statistiques, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, BOEHRINGER INGELHEIM, Boehringer Ingelheim, Internal and Cardiovascular Medicine - Stroke Unit ( PERUGIA - ICM-SU ), Università degli Studi di Perugia ( UNIPG ), Carl Gustav Carus University ( DRESDEN - CGCU ), Technische Universität Dresden ( TUD ), Service de Cardiologie, CHU Grenoble, Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département de Médecine Interne et Pneumologie [Brest] ( DMIP - Brest ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Department of Cardiology, University of Freiburg [Freiburg], Cardiovascular Division ( SZG ), Brigham and Women's Hospital [Boston], Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) ( PCVP / CARDIO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université de Franche-Comté ( UFC ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ), Service de Cardiologie A ( TOURS - Cardiologie A ), CHRU Tours, Dresden-Friedrichstadt Hospital ( DRESDEN-FRIEDRICHSTADT HOSPITAL ), Dresden-Friedrichstadt Hospital, Département de Médecine d'Urgence, Hôpital Lapeyronie, Cologne Center for Genomics (CCG), University of Cologne, Emergency Department ( FV - ED ), Saint Luc University Hospital, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Internal and Cardiovascular Medicine - Stroke Unit (PERUGIA - ICM-SU), Università degli Studi di Perugia (UNIPG), Carl Gustav Carus University (DRESDEN - CGCU), Technische Universität Dresden = Dresden University of Technology (TU Dresden), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Cardiovascular Division (SZG), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Cardiologie A (TOURS - Cardiologie A), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Dresden-Friedrichstadt Hospital (DRESDEN-FRIEDRICHSTADT HOSPITAL), Emergency Department (FV - ED), HEGP ( SPRM ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( PCVP / CARDIO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Guy Meyer, Eric Vicaut, Thierry Danay, Giancarlo Agnelli, Cecilia Becattini, Jan Beyer-Westendorf, Erich Bluhmki, Helene Bouvaist, Benjamin Brenner, Francis Couturaud, Claudia Della, Klaus Empen, Ana Franca, Nazzareno Galiè, Annette Geibel, Samuel Z. Goldhaber, David Jimenez, Matija Kozak, Christian Kupatt, Nils Kucher, Irene M. Lang, Mareike Lankeit, Nicolas Meneveau, Gerard Pacouret, Massimiliano Palazzini, Antoniu Petri, Piotr Pruszczyk, Matteo Rugolotto, Aldo Salvi, Sebastian Schellong, Mustapha Sebbane, Bozena Sobkowicz, Branislav S. Stefanovic, Holger Thiele, Adam Torbicki, Franck Verschuren, Stavros V. Konstantinides |
| Rok vydání: | 2014 |
| Předmět: |
MESH: Pulmonary Embolism
Male MESH: Heparin MESH : Stroke [SDV]Life Sciences [q-bio] medicine.medical_treatment Ventricular Dysfunction Right MESH : Aged MESH : Ventricular Dysfunction Right law.invention MESH : Tissue Plasminogen Activator MESH: Aged 80 and over Randomized controlled trial MESH: Risk Factors law Risk Factors MESH: Tissue Plasminogen Activator MESH: Fibrinolytic Agents MESH: Double-Blind Method MESH : Female Stroke MESH: Ventricular Dysfunction Right MESH: Treatment Outcome MESH: Aged Aged 80 and over MESH: Middle Aged Age Factors General Medicine Middle Aged MESH : Risk Factors Troponin 3. Good health Pulmonary embolism Treatment Outcome Anesthesia Tissue Plasminogen Activator MESH : Pulmonary Embolism Drug Therapy Combination Female MESH: Hemorrhage medicine.drug medicine.medical_specialty Randomization MESH : Male Tenecteplase 610 Medicine & health Hemorrhage MESH : Treatment Outcome MESH : Hemorrhage Placebo MESH: Stroke Double-Blind Method Fibrinolytic Agents Fibrinolysis medicine Fibrinolysi MESH : Double-Blind Method Humans Decompensation MESH : Middle Aged MESH : Aged 80 and over Aged MESH: Age Factors MESH: Humans [ SDV ] Life Sciences [q-bio] business.industry Heparin MESH : Drug Therapy Combination MESH : Humans MESH : Fibrinolytic Agents medicine.disease MESH: Male Surgery MESH: Drug Therapy Combination MESH : Troponin MESH : Heparin MESH: Troponin MESH : Age Factors business Pulmonary Embolism MESH: Female |
| Zdroj: | Meyer, Guy; Vicaut, Eric; Danays, Thierry; Agnelli, Giancarlo; Becattini, Cecilia; Beyer-Westendorf, Jan; Bluhmki, Erich; Bouvaist, Helene; Brenner, Benjamin; Couturaud, Francis; Dellas, Claudia; Empen, Klaus; Franca, Ana; Galiè, Nazzareno; Geibel, Annette; Goldhaber, Samuel Z.; Jimenez, David; Kozak, Matija; Kupatt, Christian; Kucher, Nils; ... (2014). Fibrinolysis for patients with intermediate-risk pulmonary embolism. New England journal of medicine NEJM, 370(15), pp. 1402-1411. Massachusetts Medical Society MMS 10.1056/NEJMoa1302097 BASE-Bielefeld Academic Search Engine New England Journal of Medicine New England Journal of Medicine, Massachusetts Medical Society, 2014, 370 (15), pp.1402-11. 〈10.1056/NEJMoa1302097〉 New England Journal of Medicine, Massachusetts Medical Society, 2014, 370 (15), pp.1402-11. ⟨10.1056/NEJMoa1302097⟩ |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/NEJMoa1302097 |
| Popis: | International audience; BACKGROUND: The role of fibrinolytic therapy in patients with intermediate-risk pulmonary embolism is controversial. METHODS: In a randomized, double-blind trial, we compared tenecteplase plus heparin with placebo plus heparin in normotensive patients with intermediate-risk pulmonary embolism. Eligible patients had right ventricular dysfunction on echocardiography or computed tomography, as well as myocardial injury as indicated by a positive test for cardiac troponin I or troponin T. The primary outcome was death or hemodynamic decompensation (or collapse) within 7 days after randomization. The main safety outcomes were major extracranial bleeding and ischemic or hemorrhagic stroke within 7 days after randomization. RESULTS: Of 1006 patients who underwent randomization, 1005 were included in the intention-to-treat analysis. Death or hemodynamic decompensation occurred in 13 of 506 patients (2.6%) in the tenecteplase group as compared with 28 of 499 (5.6%) in the placebo group (odds ratio, 0.44; 95% confidence interval, 0.23 to 0.87; P=0.02). Between randomization and day 7, a total of 6 patients (1.2%) in the tenecteplase group and 9 (1.8%) in the placebo group died (P=0.42). Extracranial bleeding occurred in 32 patients (6.3%) in the tenecteplase group and 6 patients (1.2%) in the placebo group (P |
| Databáze: | OpenAIRE |
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