title: Efficacy and safety of tenecteplase in pulmonary embolism.
abstract: Pulmonary embolism (PE) is a relatively common life-threatening cardiovascular condition associated with significant morbidity and mortality. We present the efficacy and safety data of weight-adjusted tenecteplase in 30 consecutive patients of acute PE. 30 patients (22 male, 8 female) with acute PE were included in the study and divided into three groups: (1) Acute PE complicated by shock stage and/or persistent hypotension (12 patients). (2) RV dilatation and/or dysfunction without hypotension (14 patients). (3) Severe hypoxemia without hypotension and RV dysfunction (4 patients). Predominant symptoms were dyspnoea, cough, chest pain, syncope and haemoptysis, noted in 100% (30), 40% (12), 54% (16), 32% (9) and 10% (3) of patients respectively. RV dilatation and dyskinesia were present in 86%, septal paradoxical movement in 73% and inferior venacava collapse absent in 53% of patients respectively. 12 patients presented with acute PE and cardiogenic shock, 14 patients showed RV dilatation and dysfunction with systolic BP >90 mmHg and four patients were having RV dilation without dysfunction but severe hypoxemia. There was significant reduction in right ventricular systolic pressure and improvement in right ventricular dysfunction. Our study shows that tenecteplase is very effective and safe in the treatment of PE with minimal risk of bleeding in high risk group and intermediate risk and even in selective low risk category group of patients. However, in view of small number of patients in study group, a large multicentre randomized study would be required to draw a firm conclusion regarding the thrombolysis in low risk category patient.
authors: U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Ahmedabad, 380016, Gujarat, India, dranand1978@yahoo.co.in.
authors: Anand N
authors: AN
authors: Shukla
authors: Bhavesh
authors: B
authors: Thakkar
authors: Ashwal A
authors: AA
authors: Jayaram
authors: Tarun H
authors: TH
authors: Madan
authors: Gaurav D
authors: GD
authors: Gandhi
mesh_terms: D000328:Adult; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006470:Hemorrhage / Q000139:chemically induced / Q000503:physiopathology; D006801:Humans; D007022:Hypotension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D000860:Hypoxia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D000077785:Tenecteplase; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase
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