Fibrinolysis for Patients with Intermediate-Risk Pulmonary Embolism

Meyer, Guy; Vicaut, Éric; Danays, Thierry; Agnelli, Giancarlo; Becattini, Cecilia; Beyer‐Westendorf, Jan; Bluhmki, Erich; Bouvaist, Hélène; Brenner, Benjamin; Couturaud, Francis; Dellas, Claudia; Empen, Klaus; França, Ana Paula Figueiredo de Montalvão; Galiè, Nazzareno; Geibel, Annette; Goldhaber, Samuel Z.; Jiménez, David; Kozak, Matija; Kupatt, Christian; Kucher, Nils; Lang, Irene M.; Lankeit, Mareike; Méneveau, Nicolas; Pacouret, G; Palazzini, Massimiliano; Petriş, Antoniu; Pruszczyk, Piotr; Rugolotto, Matteo; Salvi, Aldo; Schellong, Sebastian; Sebbane, Mustapha; Sobkowicz, Bożena; Stefanović, Branislav; Thiele, Holger; Torbicki, Adam; Verschuren, Franck; Konstantinides, Stavros

doi:10.1056/nejmoa1302097

Cited by 1,322 publications

(1,141 citation statements)

References 27 publications

Supporting

Mentioning

979

Contrasting

Unclassified

Order By: Relevance

“…The multicenter, double-blind, randomized, placebo-controlled PEITHO (Pulmonary Embolism Thrombolysis) 10 study has recently revealed that rapid thrombolysis reduces the combination of death from any cause and hemodynamic instability in seven days in patients with RV failure and myocardial injury without circulatory shock and this is mainly due to decreased risk of hemodynamic decompensation in these patients. 10 Therefore, these patients, stratified as intermediate risk, who would only receive treatment with anticoagulants, are also thrombolysis candidates with proven benefit.…”

Section: Discussionmentioning

confidence: 99%

Use of Thrombolysis in PE Said to be of no High-Risk, which Presents Acute Cor Pulmonale

Guenther¹,

Nunes²,

Souza³

et al. 2017

International Journal of Cardiovascular Sciences

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Use of Thrombolysis in PE Said to be of no High-Risk, which Presents Acute Cor Pulmonale

Guenther¹,

Nunes²,

Souza³

et al. 2017

International Journal of Cardiovascular Sciences

View full text Add to dashboard Cite

“…However, this scenario seems unlikely in light of the results of the PEITHO trial [33]. While fibrinolysis reduced the risk of decompensation in hemodynamically stable patients with PE who had RV dysfunction and elevated troponin in this trial, overall mortality did not differ, and the risk-benefit ratio of fibrinolysis was worse in patients aged >75 years [34].…”

Section: Discussionmentioning

confidence: 99%

Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism

Hofmann

Limacher

Méan

et al. 2016

Thrombosis Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…The potential for home treatment or short hospitalisation for patients with a low risk of pulmonary embolism needs to be confirmed in further randomised clinical trials. The need for treatment upgrading for patients at intermediate-high risk of death has been only partially shown by randomised clinical trials, as thrombolytic therapy reduces the rate of in-hospital clinical deterioration but not mortality [24][25][26][27][28][29][30][31].…”

Section: Relationship Between Pathophysiology and Risk Of In-hospitalmentioning

confidence: 99%

Anticoagulant treatment for acute pulmonary embolism: a pathophysiology-based clinical approach

Agnelli

Becattini

2015

Eur Respir J

Self Cite

View full text Add to dashboard Cite

The management of patients with acute pulmonary embolism is made challenging by its wide spectrum of clinical presentation and outcome, which is mainly related to patient haemodynamic status and right ventricular overload. Mechanical embolic obstruction and neurohumorally mediated pulmonary vasoconstriction are responsible for right ventricular overload. The pathophysiology of acute pulmonary embolism is the basis for risk stratification of patients as being at high, intermediate and low risk of adverse outcomes. This risk stratification has been advocated to tailor clinical management according to the severity of pulmonary embolism.Anticoagulation is the mainstay of the treatment of acute pulmonary embolism. New direct oral anticoagulants, which are easier to use than conventional anticoagulants, have been compared with conventional anticoagulation in five randomised clinical trials including >11 000 patients with pulmonary embolism. Patients at high risk of pulmonary embolism (those with haemodynamic compromise) were excluded from these studies. Direct oral anticoagulants have been shown to be as effective and at least as safe as conventional anticoagulation in patients with pulmonary embolism without haemodynamic compromise, who are the majority of patients with this disease. Whether these agents are appropriate for the acute-phase treatment of patients at intermediate-high risk pulmonary embolism (those with both right ventricle dysfunction and injury) regardless of any risk stratification remains undefined. @ERSpublications New oral anticoagulants are efficacious and safe in haemodynamically stable patients with acute pulmonary embolism http://ow.ly/I2iP5

show abstract

Fibrinolysis for Patients with Intermediate-Risk Pulmonary Embolism

Cited by 1,322 publications

References 27 publications

Use of Thrombolysis in PE Said to be of no High-Risk, which Presents Acute Cor Pulmonale

Use of Thrombolysis in PE Said to be of no High-Risk, which Presents Acute Cor Pulmonale

Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism

Anticoagulant treatment for acute pulmonary embolism: a pathophysiology-based clinical approach

Contact Info

Product

Resources

About