Impact of the efficacy of thrombolytic therapy on the mortality of patients with acute submassive pulmonary embolism: a meta‐analysis

@article{Nakamura2014ImpactOT,
  title={Impact of the efficacy of thrombolytic therapy on the mortality of patients with acute submassive pulmonary embolism: a meta‐analysis},
  author={S Nakamura and Hitoshi Takano and Yoshikazu Kubota and K Asai and Wataru Shimizu},
  journal={Journal of Thrombosis and Haemostasis},
  year={2014},
  volume={12},
  pages={1086 - 95}
}
BACKGROUND The efficacy of thrombolytic therapy in patients with submassive pulmonary embolism (PE) remains unclear. [...] Key MethodMETHODS The MEDLINE, EMBASE and Cochrane Library databases were searched to identify all relevant randomized controlled trials comparing adjunctive thrombolytic therapy with heparin alone as initial treatments in patients with acute submassive PE, and reported 30-day mortality or in-hospital clinical outcomes. RESULTS A total of 1510 patients were enrolled in this meta-analysis…Expand
The net benefit of thrombolysis in the management of intermediate risk pulmonary embolism: Systematic review and meta‐analysis
Benefit of thrombolytic therapy in patients with massive pulmonary embolism (PE) is evident. However, evidence supporting benefit in clinical outcomes of this approach in intermediate risk PE isExpand
[Thrombolytic therapy for submassive/ intermediate risk Pulmonary Embolism Evidence and suggestions after PEITHO trial].
TLDR
The relevant literature is reviewed, prognostic factors are outlined, and current recommendations and controversies regarding the available alternatives such as systemic and catheter-directed thrombolytic use are discussed. Expand
Acute pulmonary embolism: endovascular therapy.
TLDR
A multidisciplinary approach to diagnosis, risk stratification, and therapy is required to determine which treatment option is best for a given patient with this complex disease. Expand
Clinical update on thrombolytic use in pulmonary embolism: A focus on intermediate‐risk patients
TLDR
The use of thrombolysis in the treatment of intermediate‐risk PE is complicated by high rates of bleeding and should be limited to patients who clinically deteriorate rather than given as a standard‐of‐care treatment in this population. Expand
Endovascular therapy for acute severe pulmonary embolism
  • Q. Javed, A. Sista
  • Medicine
  • The International Journal of Cardiovascular Imaging
  • 2019
TLDR
This review will focus on therapies currently available to manage acute massive and submassive PE and current prognostic stratification separates acute PE into massive, submassive, and low-risk. Expand
Current Endovascular Treatment Options in Acute Pulmonary Embolism
TLDR
The risk stratification of acute PE is discussed and the data supporting the use of endovascular treatment options in acute PE are reviewed and the potential role of the PE response team is described. Expand
Thrombolysis in Pulmonary Embolism: An Evidence-Based Approach to Treating Life-Threatening Pulmonary Emboli.
TLDR
Patients with PE and right ventricular dysfunction/injury, but without hypotension ("submassive PE"), should be considered for thrombolysis on a case-by-case basis, considering bleeding risk, cardiac biomarkers, echocardiography, and most importantly, clinical status. Expand
The effect of fibrinolytic therapy on 30-day outcome in patients with intermediate risk pulmonary embolism - propensity score-adjusted analysis
TLDR
The use of FT was associated with a better outcome compared to AT in patients with submassive PE, but the benefit was mainly driven from those with highest values of PS, i.e. with the highest baseline risk. Expand
Initial thrombolysis treatment compared with anticoagulation for acute intermediate-risk pulmonary embolism: a meta-analysis.
TLDR
Thrombolytic treatment for intermediate-risk PE patients, if not contraindicated, could reduce clinical deterioration and recurrence of PE, and trends towards a decrease in all-cause, 30-day mortality. Expand
The role of thrombolytic therapy in pulmonary embolism.
TLDR
The aim of this review is to provide evidence-based practice recommendations for the use of thrombolytic therapies in the treatment of PE with and without hemodynamic instability, and to determine the optimal regimen of throttletic therapy based on available data. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 43 REFERENCES
Treatment of submassive pulmonary embolism with tenecteplase or placebo: cardiopulmonary outcomes at 3 months: multicenter double‐blind, placebo‐controlled randomized trial
TLDR
A patient's quality of life can be affected by acute pulmonary embolism due to persistent dyspnea or exercise intolerance, especially if the patient has a history of chronic obstructive pulmonary disease. Expand
Thrombolytic therapy of pulmonary embolism: a meta-analysis.
TLDR
Compared with intravenous heparin, thrombolytic therapy does not appear to have therapeutic benefit in unselected patients with acute PE, but it is associated with an increased risk of major hemorrhage. Expand
Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC).
Non-thrombotic PE does not represent a distinct clinical syndrome. It may be due to a variety of embolic materials and result in a wide spectrum of clinical presentations, making the diagnosisExpand
Thrombolysis vs heparin in the treatment of pulmonary embolism: a clinical outcome-based meta-analysis.
TLDR
A comparative clinical outcome trial of thrombolysis and heparin treatment is warranted in patients with pulmonary embolism and selected for high risk of death and/or recurrence and low risk of bleeding. Expand
Thrombolysis Compared With Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials
TLDR
Currently available data provide no evidence for a benefit of thrombolytic therapy compared with heparin for the initial treatment of unselected patients with acute pulmonary embolism, but a benefit is suggested in those at highest risk of recurrence or death. Expand
Moderate pulmonary embolism treated with thrombolysis (from the "MOPETT" Trial).
TLDR
It is suggested that "safe dose" thrombolysis is safe and effective in the treatment of moderate PE, with a significant immediate reduction in the pulmonary artery pressure that was maintained at 28 months. Expand
In-hospital and long-term outcome after sub-massive and massive pulmonary embolism submitted to thrombolytic therapy.
TLDR
The recovery of RV function should be considered as a marker of thrombolysis efficacy, while residual pulmonary vascular obstruction and cancer are independent predictors of long-term mortality. Expand
ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.
TLDR
The once-in-a-lifetime treatment with Abciximab Intracoronary for acute coronary syndrome and a second dose intravenously for atrial fibrillation is recommended for adults with high blood pressure. Expand
HEPARIN PLUS ALTEPLASE COMPARED WITH HEPARIN ALONE IN PATIENTS WITH SUBMASSIVE PULMONARY EMBOLISM
TLDR
When given in conjunction with heparin, alteplase can improve the clinical course of stable patients who have acute submassive pulmonary embolism and can prevent clinical deterioration requiring the escalation of treatment during the hospital stay. Expand
PAIMS 2: alteplase combined with heparin versus heparin in the treatment of acute pulmonary embolism. Plasminogen activator Italian multicenter study 2.
TLDR
Alteplase resulted in a greater and faster improvement of the angiographic and hemodynamic variables compared with heparin, and the high frequency of bleeding observed with altePlase in this trial suggests that patients should be carefully selected before thrombolytic therapy is given. Expand
...
1
2
3
4
5
...