RT Journal Article
SR Electronic
T1 Clinical efficacy of low dose recombinant tissue-type plasminogen activator for the treatment of acute intermediate-risk pulmonary embolism
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1090
OP 1095
DO 10.15537/smj.2018.11.22717
VO 39
IS 11
A1 Zhang, Ling-Yun
A1 Gao, Bao-An
A1 Jin, Zhu
A1 Xiang, Guang-Ming
A1 Gong, Zheng
A1 Zhang, Ting-Ting
A1 Lu, Hong-Fang
A1 Wang, Yong-Quan
A1 Gong, Yuan
A1 Lu, Cheng
A1 Huang, Wei-Ling
YR 2018
UL http://smj.org.sa/content/39/11/1090.abstract
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.