The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant Drugs
Relevance Chronic post-embolic pulmonary hypertension (CPEPH) is a complication of pulmonary thromboembolism found almost in every 10th patient. A special risk group consists of patients with a moderately high risk of pulmonary embolism associated death according to stratification of the probability...
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| Format: | Article |
| Language: | Russian |
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Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
2019-11-01
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| Series: | Неотложная медицинская помощь |
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| Online Access: | https://www.jnmp.ru/jour/article/view/687 |
| _version_ | 1797705336365252608 |
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| author | A. G. Pronin |
| author_facet | A. G. Pronin |
| author_sort | A. G. Pronin |
| collection | DOAJ |
| description | Relevance Chronic post-embolic pulmonary hypertension (CPEPH) is a complication of pulmonary thromboembolism found almost in every 10th patient. A special risk group consists of patients with a moderately high risk of pulmonary embolism associated death according to stratification of the probability of early death of the European Society of Cardiology. The development of this condition is potentially preventable with timely and adequate therapy in these patients. We have improved the approach to the treatment of pulmonary embolism patients, which allows indications for thrombolytic therapy to be clarified and expanded. The aim of the study is to evaluate its effectiveness in the long-term period, as well as analyze the qualities of life of patients with massive pulmonary embolism, who underwent thrombolytic and anticoagulant therapy.Material and methods The treatment, as well as the analysis of long-term results and quality of life of 71 patients aged 29 to 88 years with diagnosed pulmonary embolism with a moderately high risk of early death were performed. All patients underwent general clinical and biochemical blood tests, D-dimer, ECG, echocardiography, ultrasound of the lower extremities veins, CT angiopulmonography. We registered the dynamics of echocardiographic symptoms of the right heart overload over 6 months (right ventricle size, pulmonary hypertension, the degree of tricuspid regurgitation), and assessed the quality of life based on a survey with the establishment of the appearance of shortness of breath, tachycardia, hospitalizations for heart failure during the study period. Depending on the type of therapy, the patients were divided into two groups: 38 patients with thrombolytic therapy and 33 patients with anticoagulant therapy. Subsequently, their comparative analysis was carried out.Results and conclusion In patients with pulmonary embolism of moderately high risk of early death, who underwent thrombolytic therapy, chronic postembolic pulmonary hypertension developed 2.9 times less and a higher quality of life retained in these patients than in patients treated with anticoagulant drugs. |
| first_indexed | 2024-03-12T05:34:37Z |
| format | Article |
| id | doaj.art-960c1459f52241aaa4d68ffd1acb0e43 |
| institution | Directory Open Access Journal |
| issn | 2223-9022 2541-8017 |
| language | Russian |
| last_indexed | 2024-03-12T05:34:37Z |
| publishDate | 2019-11-01 |
| publisher | Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department |
| record_format | Article |
| series | Неотложная медицинская помощь |
| spelling | doaj.art-960c1459f52241aaa4d68ffd1acb0e432023-09-03T06:32:52ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172019-11-018327427810.23934/2223-9022-2019-8-3-274-278527The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant DrugsA. G. Pronin0N.I. Pirogov National Medical and Surgical CenterRelevance Chronic post-embolic pulmonary hypertension (CPEPH) is a complication of pulmonary thromboembolism found almost in every 10th patient. A special risk group consists of patients with a moderately high risk of pulmonary embolism associated death according to stratification of the probability of early death of the European Society of Cardiology. The development of this condition is potentially preventable with timely and adequate therapy in these patients. We have improved the approach to the treatment of pulmonary embolism patients, which allows indications for thrombolytic therapy to be clarified and expanded. The aim of the study is to evaluate its effectiveness in the long-term period, as well as analyze the qualities of life of patients with massive pulmonary embolism, who underwent thrombolytic and anticoagulant therapy.Material and methods The treatment, as well as the analysis of long-term results and quality of life of 71 patients aged 29 to 88 years with diagnosed pulmonary embolism with a moderately high risk of early death were performed. All patients underwent general clinical and biochemical blood tests, D-dimer, ECG, echocardiography, ultrasound of the lower extremities veins, CT angiopulmonography. We registered the dynamics of echocardiographic symptoms of the right heart overload over 6 months (right ventricle size, pulmonary hypertension, the degree of tricuspid regurgitation), and assessed the quality of life based on a survey with the establishment of the appearance of shortness of breath, tachycardia, hospitalizations for heart failure during the study period. Depending on the type of therapy, the patients were divided into two groups: 38 patients with thrombolytic therapy and 33 patients with anticoagulant therapy. Subsequently, their comparative analysis was carried out.Results and conclusion In patients with pulmonary embolism of moderately high risk of early death, who underwent thrombolytic therapy, chronic postembolic pulmonary hypertension developed 2.9 times less and a higher quality of life retained in these patients than in patients treated with anticoagulant drugs.https://www.jnmp.ru/jour/article/view/687pulmonary embolismanticoagulant therapythrombolytic therapychronic post-embolic pulmonary hypertension |
| spellingShingle | A. G. Pronin The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant Drugs Неотложная медицинская помощь pulmonary embolism anticoagulant therapy thrombolytic therapy chronic post-embolic pulmonary hypertension |
| title | The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant Drugs |
| title_full | The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant Drugs |
| title_fullStr | The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant Drugs |
| title_full_unstemmed | The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant Drugs |
| title_short | The Analysis of Long-Term Results and Quality of Life in Patients with Massive Pulmonary Embolism in the Course of Treatment with Thrombolytic and Anticoagulant Drugs |
| title_sort | analysis of long term results and quality of life in patients with massive pulmonary embolism in the course of treatment with thrombolytic and anticoagulant drugs |
| topic | pulmonary embolism anticoagulant therapy thrombolytic therapy chronic post-embolic pulmonary hypertension |
| url | https://www.jnmp.ru/jour/article/view/687 |
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