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https://doi.org/10.15836/ccar2022.292

Systemic thrombolytic therapy in patients with intermediate-high-risk pulmonary embolism

Karlo Golubić orcid id orcid.org/0000-0003-0684-6333
Nikola Kos orcid id orcid.org/0000-0001-8829-2543
Tonći Batinić orcid id orcid.org/0000-0002-8431-6963
Mislav Vrsalović


Puni tekst: engleski pdf 136 Kb

str. 292-292

preuzimanja: 80

citiraj

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Sažetak

Ključne riječi

pulmonary embolism; thrombolytic therapy

Hrčak ID:

289805

URI

https://hrcak.srce.hr/289805

Datum izdavanja:

8.12.2022.

Posjeta: 211 *



Pulmonary embolism remains the one of the commonest cardiovascular disease, the severity of which is variable and can be lethal. The incidence is expected to increase due to the aging population. Intermediate-high risk pulmonary embolism is characterized by hemodynamical stability, but elevated mortality risk and both radiographic and laboratory signs of right heart strain. Thrombolysis remains a possible life saving treatment option but bears an increased risk of potentially life-threatening hemorrhage. Optimal treatment is still not established. (1-3) We present a series of intermediate-high risk patients treated in our hospital with thrombolytic therapy (n=4, 2 male, median age 58.5) and compare relevant direct and indirect values of right ventricular load before and after treatment (Table 1). We also provide a summary of our clinical approach in light of current guidelines and two meta-analyses.

TABLE 1 Comparison of relevant direct and indirect values of right ventricular load before and after treatment.
Before treatmentAfter treatment
SO2 (%)TnI (ng/L)NTproBNP (ng/L)SO2 (%)TnI (ng/L)NTproBNP (ng/L)
806576103983583
8261352292<10145
841909122972622976
94125259796<10139

LITERATURE

1 

Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020 January 21;41(4):543–603. https://doi.org/10.1093/eurheartj/ehz405 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/31504429

2 

Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, et al. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA. 2014 June 18;311(23):2414–21. https://doi.org/10.1001/jama.2014.5990 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/24938564

3 

Zuo Z, Yue J, Dong BR, Wu T, Liu GJ, et al. Thrombolytic therapy for pulmonary embolism. Cochrane Database Syst Rev. 2021 April 15;4(4):CD004437. https://doi.org/10.1002/14651858.CD004437.pub6 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/33857326


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