title: Low-molecular-weight heparin use with thrombolysis: is it effective and safe? Ten years' clinical experience.
abstract: BACKGROUND
  There is no data on the use of subcutaneous low-molecular-weight heparin (SC LMWH) in cases that require thrombolysis.
  
  
  OBJECTIVE
  Having used SC LMWH with thrombolytics for more than 10 years, we aimed to review our data, share our experiences and find out whether the use of SC LMWH with thrombolytics had been effective and safe.
  
  
  METHODS
  This is a retrospective cohort study. Patients who were diagnosed as acute pulmonary embolism (PE) and received either SC LMWH treatment or SC LMWH with thrombolytics in our hospital (a tertiary hospital) between 2000 and 2010 were included in the study. For both treatments, the rates of mortality and complications were calculated.
  
  
  RESULTS
  A total of 392 patients, 210 female (53.5%) and 182 male (46.5%) with an average age of 60 years, ±16 SD, with acute PE, were included in the study. Of these patients, 107 (27.2%) were massive and 285 (72.8%) were nonmassive and were administered SC LMWH plus thrombolytics and only SC LMWH, respectively. The mortality rate was 16.8% (18 of 107) in patients who were massive and 3.5% (10 of 285) for those who were nonmassive (p < 0.001). Major hemorrhage occurred in 3.7% (n = 4) and 0.7% (n = 2) and minor hemorrhage in 12.1% (n = 13) and in 3.8% (n = 11) of the cases who received SC LMWH plus thrombolytics and SC LMWH, respectively.
  
  
  CONCLUSIONS
  SC LMWH use with thrombolytics seems to be feasible and safe. Prospective, large, randomized control trials are still required in order to confirm these results.
authors: Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey.
authors: Elif Yilmazel
authors: EY
authors: Ucar
authors: Omer
authors: O
authors: Araz
authors: Metin
authors: M
authors: Akgun
authors: Mehmet
authors: M
authors: Meral
authors: Fikriye
authors: F
authors: Kalkan
authors: Leyla
authors: L
authors: Saglam
authors: Hasan
authors: H
authors: Kaynar
authors: Ali Metin
authors: AM
authors: Gorguner
mesh_terms: D000328:Adult; D000368:Aged; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D013300:Streptokinase / Q000627:therapeutic use*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014421:Turkey / Q000453:epidemiology
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D013300:Streptokinase; D010959:Tissue Plasminogen Activator