Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary Embolism

Objective: Thrombolytic and anticoagulation therapy modalities are the possible treatment for submassive pulmonary embolism (PE). However, the indications are still the subject of debate. The aim of the present study was to compare the efficacies of thrombolytic and standard anticoagulation treatmen...

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Main Authors: Pınar Çimen, Dursun Alizoroğlu, Mehmet Ünlü, Cenk Kıraklı, Özlem Ediboğlu, Ahmet Emin Erbaycu
Format: Article
Language:English
Published: KARE Publishing 2019-05-01
Series:Erciyes Medical Journal
Subjects:
Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-80008
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author Pınar Çimen
Dursun Alizoroğlu
Mehmet Ünlü
Cenk Kıraklı
Özlem Ediboğlu
Ahmet Emin Erbaycu
author_facet Pınar Çimen
Dursun Alizoroğlu
Mehmet Ünlü
Cenk Kıraklı
Özlem Ediboğlu
Ahmet Emin Erbaycu
author_sort Pınar Çimen
collection DOAJ
description Objective: Thrombolytic and anticoagulation therapy modalities are the possible treatment for submassive pulmonary embolism (PE). However, the indications are still the subject of debate. The aim of the present study was to compare the efficacies of thrombolytic and standard anticoagulation treatment modalities on mortality and also to determine the safety of thrombolytic treatment in subjects with submassive PE. Materials and Methods: Subjects with submassive PE were recruited from the intensive care unit (ICU). Demographic data, comorbidity, bedside echocardiography (ECHO) findings, treatment procedure, treatment-related side effects, and total length of stay in the hospital and ICU were collected. Control ECHO was performed 48 h after the initiation of treatment. Short-term and 1-year mortality rates were recorded. The correlation between the increased risk for major bleeding and thrombolytic treatment was assessed. Results: A total of 54 subjects were enrolled during the study period. The median age of the subjects was 66 (54–73) years. Of the 54 subjects, 18 (33.3%) underwent thrombolytic treatment, and 36 (66.7%) received standard anticoagulation therapy. Short-term and 1-year mortality rates were statistically lower in subjects who received thrombolytic therapy (p=0.02 and p=0.04, respectively). The reduction in mean pulmonary arterial pressure was significantly higher in the thrombolytic treatment group (p<0.001). Risk for major bleeding was similar between the two. Conclusion: Thrombolytic therapy may reduce the mortality rates in subjects with submassive PE without an increase in the risk of major bleeding.
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spelling doaj.art-f50874f36b0b4ddbbaabe9e9808a0a432023-02-15T16:17:09ZengKARE PublishingErciyes Medical Journal2149-22472019-05-0141217517910.14744/etd.2019.80008EMJ-80008Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary EmbolismPınar Çimen0Dursun Alizoroğlu1Mehmet Ünlü2Cenk Kıraklı3Özlem Ediboğlu4Ahmet Emin Erbaycu5Department of Intensive Care, University of Health Sciences İzmir Training and Research Hospital for Thoracic Medicine and Surgery, İzmir, TurkeyDepartment of Intensive Care, University of Health Sciences İzmir Training and Research Hospital for Thoracic Medicine and Surgery, İzmir, TurkeyDepartment of Intensive Care, University of Health Sciences İzmir Training and Research Hospital for Thoracic Medicine and Surgery, İzmir, TurkeyDepartment of Intensive Care, University of Health Sciences İzmir Training and Research Hospital for Thoracic Medicine and Surgery, İzmir, TurkeyDepartment of Intensive Care, University of Health Sciences İzmir Training and Research Hospital for Thoracic Medicine and Surgery, İzmir, TurkeyDepartment of Thoracic Disease, University of Health Sciences, İzmir Training and Research Hospital for Thoracic Medicine and Surgery, İzmir, TurkeyObjective: Thrombolytic and anticoagulation therapy modalities are the possible treatment for submassive pulmonary embolism (PE). However, the indications are still the subject of debate. The aim of the present study was to compare the efficacies of thrombolytic and standard anticoagulation treatment modalities on mortality and also to determine the safety of thrombolytic treatment in subjects with submassive PE. Materials and Methods: Subjects with submassive PE were recruited from the intensive care unit (ICU). Demographic data, comorbidity, bedside echocardiography (ECHO) findings, treatment procedure, treatment-related side effects, and total length of stay in the hospital and ICU were collected. Control ECHO was performed 48 h after the initiation of treatment. Short-term and 1-year mortality rates were recorded. The correlation between the increased risk for major bleeding and thrombolytic treatment was assessed. Results: A total of 54 subjects were enrolled during the study period. The median age of the subjects was 66 (54–73) years. Of the 54 subjects, 18 (33.3%) underwent thrombolytic treatment, and 36 (66.7%) received standard anticoagulation therapy. Short-term and 1-year mortality rates were statistically lower in subjects who received thrombolytic therapy (p=0.02 and p=0.04, respectively). The reduction in mean pulmonary arterial pressure was significantly higher in the thrombolytic treatment group (p<0.001). Risk for major bleeding was similar between the two. Conclusion: Thrombolytic therapy may reduce the mortality rates in subjects with submassive PE without an increase in the risk of major bleeding.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-80008submassive pulmonary embolismthrombolytic therapyanticoagulation treatment
spellingShingle Pınar Çimen
Dursun Alizoroğlu
Mehmet Ünlü
Cenk Kıraklı
Özlem Ediboğlu
Ahmet Emin Erbaycu
Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary Embolism
Erciyes Medical Journal
submassive pulmonary embolism
thrombolytic therapy
anticoagulation treatment
title Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary Embolism
title_full Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary Embolism
title_fullStr Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary Embolism
title_full_unstemmed Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary Embolism
title_short Safety and Effectiveness of Thrombolytic Therapy Compared with Standard Anticoagulation in Subjects with Submassive Pulmonary Embolism
title_sort safety and effectiveness of thrombolytic therapy compared with standard anticoagulation in subjects with submassive pulmonary embolism
topic submassive pulmonary embolism
thrombolytic therapy
anticoagulation treatment
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-80008
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AT mehmetunlu safetyandeffectivenessofthrombolytictherapycomparedwithstandardanticoagulationinsubjectswithsubmassivepulmonaryembolism
AT cenkkıraklı safetyandeffectivenessofthrombolytictherapycomparedwithstandardanticoagulationinsubjectswithsubmassivepulmonaryembolism
AT ozlemediboglu safetyandeffectivenessofthrombolytictherapycomparedwithstandardanticoagulationinsubjectswithsubmassivepulmonaryembolism
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