Efficacy and safety of high dose versus low dose streptokinase for treatment of submassive pulmonary embolism

Abdelsamad, Ayman A.; El-Morsi, Ahmad S.; Mansour, Ahmad E.

doi:10.1016/j.ehj.2011.09.006

Cited by 8 publications

(2 citation statements)

References 21 publications

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“…[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] An additional 16 studies compared different types of thrombolytic agents, and included a total of 1244 patients (supplemental Appendix 5). [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] One study (Ultrasound-Accelerated Thrombolysis of Pulmonary Embolism [ULTIMA] trial) investigated catheter-directed thrombolysis (CDT), and enrolled a total of 59 patients. 42 All studies were randomized, but only 7 were clearly blinded.…”

Section: Resultsmentioning

confidence: 99%

The role of thrombolytic therapy in pulmonary embolism

Wang

Squizzato

Dentali

et al. 2015

Blood

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Case presentationM.T. is a 37-year-old white male with no significant past medical history who presented with sudden onset of tachypnea and chest pain, and was found to have hypoxia with oxygen saturation of 85% on room air. His heart rate was elevated to between 120 and 130 bpm, and his systolic blood pressure ranged from ∼100 to 110 mm Hg. On examination, he appeared to be uncomfortable due to dyspnea. A computed tomography angiogram of the chest showed extensive acute pulmonary emboli in bilateral main pulmonary arteries and a saddle embolism at the bifurcation. Echocardiogram revealed moderately enlarged right ventricle with reduced systolic function and right ventricular pressure elevated to 50 mm Hg, estimated from the gradient over the tricuspid valve. His troponin level was negative. He was immediately started on anticoagulation. He denied a recent history of surgery, long trip, immobilization, and major trauma. You were asked to evaluate this patient and wondered whether he would benefit from thrombolysis.

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Section: Resultsmentioning

confidence: 99%

The role of thrombolytic therapy in pulmonary embolism

Wang

Squizzato

Dentali

et al. 2015

Blood

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“…A recent network meta-analysis evaluated 4 trials (17–20) (298 patients) that compared low dose to standard dose thrombolysis (21). In this meta-analysis, there was no statistically significant difference in overall mortality (OR 0.96, 95% CI, 0.23-4.17), or major bleeding, although low dose showed a nonsignificant trend towards reduced major bleeding events (OR 0.44, 95% CI, 0.15-1.28), which needs to be confirmed in larger studies.…”

Section: Aggressive Treatment Of Intermediate-risk Pulmonary Embolismmentioning

confidence: 99%

Aggressive Treatment of Intermediate-Risk Patients with Acute Symptomatic Pulmonary Embolism

Jiménez

Bikdeli

Marshall

et al. 2018

Clinics in Chest Medicine

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Contemporary studies of acute pulmonary embolism (PE) have evaluated the role of thrombolytics in intermediate-risk PE. Significant findings are that thrombolytic therapy may prevent hemodynamic deterioration and all-cause mortality but increases major bleeding. Benefits and harms are finely balanced with no convincing net benefit from thrombolytic therapy among unselected patients. Among patients with intermediate risk PE, additional prognostic factors or subtle hemodynamic changes might alter the risk-benefit assessment in favor of thrombolytic therapy before obvious hemodynamic instability.

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Thrombolytic therapy for pulmonary embolism

Qin

Dong

Yue

et al. 2015

Cochrane Database of Systematic Reviews

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There is low quality evidence that thrombolytics reduce death following acute pulmonary embolism compared with heparin. Furthermore, thrombolytic therapies included in the review were heterogeneous. Thrombolytic therapy may be helpful in reducing the recurrence of pulmonary emboli but may cause more major and minor haemorrhagic events and stroke. More high quality double blind RCTs assessing safety and cost-effectiveness are required.

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Efficacy and safety of high dose versus low dose streptokinase for treatment of submassive pulmonary embolism

Cited by 8 publications

References 21 publications

The role of thrombolytic therapy in pulmonary embolism

The role of thrombolytic therapy in pulmonary embolism

Aggressive Treatment of Intermediate-Risk Patients with Acute Symptomatic Pulmonary Embolism

Thrombolytic therapy for pulmonary embolism

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