Comparison of 5 acute pulmonary embolism mortality risk scores in patients with COVID-19

Rodrigues, Tiago; Silva, Beatriz Valente; Plácido, Rui; Mendonça, Carlos; Urbano, Maria Luísa; Rigueira, J; Almeida, Ana G.; Pinto, Fausto J.

doi:10.1016/j.ijcha.2022.100984

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…In intermediate-high and high-risk patients, Bova and sPESI are 2 scoring systems used to predict short-term mortality at 30 days post-PE. [19][20][21][22] In KNOCOUT PE, 55.6% of patients had an sPESI score ≥1, which correlates with a 30-day mortality rate of 10.9%. Of the 477 patients in KNOCOUT PE with intermediate-high risk PE for whom Bova scores could be calculated, the mean score was 4.4 (SD=0.61); a Bova score of >4 correlates with 42% of patients experiencing PE-related complications and a 10% PE-related mortality.…”

Section: Discussionmentioning

confidence: 99%

Prospective Multicenter International Registry of Ultrasound-Facilitated Catheter-Directed Thrombolysis in Intermediate-High and High-Risk Pulmonary Embolism (KNOCOUT PE)

Sterling,

Goldhaber,

Sharp

et al. 2024

Circ: Cardiovascular Interventions

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BACKGROUND: Prior clinical trials have demonstrated the efficacy of ultrasound-facilitated catheter-directed thrombolysis (USCDT) for the treatment of acute intermediate-risk pulmonary embolism (PE) using reduced thrombolytic doses and shorter infusion durations. However, utilization and safety of such strategies in broader PE populations remain unclear. The KNOCOUT PE (The EKoSoNic Registry of the Treatment and Clinical Outcomes of Patients With Pulmonary Embolism) registry is a multicenter international registry designed to study the treatment of acute PE with USCDT, with focus on safety outcomes. METHODS: The KNOCOUT PE prospective cohort included 489 patients (64 sites internationally) with acute intermediate-high or high-risk PE treated with USCDT between March 2018 and June 2020. Principal safety outcomes were independently adjudicated International Society on Thrombosis and Haemostasis major bleeding at 72 hours post-treatment and mortality within 12 months of treatment. Additional outcomes included change in right ventricular/left ventricular ratio and quality of life measures over 12 months. RESULTS: Mean alteplase (r-tPA [recombinant tissue-type plasminogen activator]) infusion duration was 10.5 hours. Mean total r-tPA dose was 18.1 mg, with 31.0% of patients receiving ≤12 mg. Major bleeding events within 72 hours occurred in 1.6% (8/489) of patients. One patient experienced worsening of a preexisting subdural hematoma after USCDT and therapeutic anticoagulation, which ultimately required surgery. All-cause mortality at 30 days was 1.0% (5/489). Improvement in PE quality of life score was observed with a 41.1% (243/489, 49.7%) and 44.2% (153/489, 31.3%) mean relative reduction by 3 and 12 months, respectively. CONCLUSIONS: In a prospective observational cohort study of patients with intermediate-high and high-risk PE undergoing USCDT, mean r-tPA dose was 18 mg, and the rates of major bleeding and mortality were low. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03426124.

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Section: Discussionmentioning

confidence: 99%

Prospective Multicenter International Registry of Ultrasound-Facilitated Catheter-Directed Thrombolysis in Intermediate-High and High-Risk Pulmonary Embolism (KNOCOUT PE)

Sterling,

Goldhaber,

Sharp

et al. 2024

Circ: Cardiovascular Interventions

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“…The global COVID-19 epidemic that erupted at the end of 2019 is now endemic and firmly entrenched as a comorbidity to be considered in patient care. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a new trigger of thromboinflammatory disease that can have long-term impact on existing and developing clinical conditions and the response to therapeutic intervention [1] , [2] , [3] .…”

mentioning

confidence: 99%

Recent highlights on specific aspects of oral anticoagulation in difficult clinical scenarios from the International Journal of Cardiology Heart & Vasculature

Fender,

Dobrev

2023

IJC Heart & Vasculature

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Comparison of 5 acute pulmonary embolism mortality risk scores in patients with COVID-19

Cited by 2 publications

References 19 publications

Prospective Multicenter International Registry of Ultrasound-Facilitated Catheter-Directed Thrombolysis in Intermediate-High and High-Risk Pulmonary Embolism (KNOCOUT PE)

Prospective Multicenter International Registry of Ultrasound-Facilitated Catheter-Directed Thrombolysis in Intermediate-High and High-Risk Pulmonary Embolism (KNOCOUT PE)

Recent highlights on specific aspects of oral anticoagulation in difficult clinical scenarios from the International Journal of Cardiology Heart & Vasculature

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