Thrombolytic therapy in the treatment of acute sub-massive pulmonary embolism: a prospective observational study.
The use of thrombolytic therapy in haemodynamically stable patients with sub-massive pulmonary embolism is still controversial. We conducted this study to observe the safety and efficacy of thrombolytic therapy in acute pulmonary embolism patients with normal blood pressure in a tertiary cardiac centre. In this study, 130 patients with sub-massive pulmonary embolism who had right-ventricular dysfunction were included and treated with thrombolytic therapy. Forty-one percent of patients in our study were within 40 years of age. Eighty-three percent of patients had clinical improvement. Both right-ventricular dysfunction and pulmonary artery systolic pressure were improved significantly following thrombolytic therapy from baseline (49 vs. 28 mmHg; P = 0.01; 95% confidence interval -13 to -56). Only 9% patients had died and two patients had intra-cerebral haemorrhage during this study. Thrombolytic therapy may be helpful in improving clinical course following sub-massive acute pulmonary embolism, especially for those who had low risk of bleeding. Further randomized study with large sample size is needed for final conclusion.
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka, India.
Soumya
S
Patra
Navin
N
Agrawal
Cholenhally Nanjappa
CN
Manjunath
Chamrajnagara M
CM
Nagesh
Budnur C
BC
Srinivas
Krishnappa Shankarappa
KS
Ravindranath
Babu
B
Reddy
D000328:Adult; D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000188:drug therapy*; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D005343:Fibrinolytic Agents