PT - JOURNAL ARTICLE AU - Ling-Yun Zhang AU - Bao-An Gao AU - Zhu Jin AU - Guang-Ming Xiang AU - Zheng Gong AU - Ting-Ting Zhang AU - Hong-Fang Lu AU - Yong-Quan Wang AU - Yuan Gong AU - Cheng Lu AU - Wei-Ling Huang TI - Clinical efficacy of low dose recombinant tissue-type plasminogen activator for the treatment of acute intermediate-risk pulmonary embolism AID - 10.15537/smj.2018.11.22717 DP - 2018 Nov 01 TA - Saudi Medical Journal PG - 1090--1095 VI - 39 IP - 11 4099 - http://smj.org.sa/content/39/11/1090.short 4100 - http://smj.org.sa/content/39/11/1090.full SO - Saudi Med J2018 Nov 01; 39 AB - 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<0.001) and the mean RV/LV ratio was reduced from 1.26±0.22 at baseline to 0.96±0.18 (p<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.