Should Low-Molecular-Weight Heparin be Preferred Over Unfractionated Heparin After Thrombolysis for Severity Pulmonary Embolism?
[ X ]
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Sage Publications Inc
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Purpose: The role of low-molecular-weight heparin (LMWH) in managing nonmassive pulmonary embolism (PE) is well known. In unstable cases, especially after thrombolytic therapy for massive PE, unfractionated heparin (UFH) is preferred for PE management. This study aimed to investigate the effectiveness and safety of LMWH after thrombolytic therapy. Methods: A prospective, observational multicenter trial was performed in 249 patients with acute PE who required thrombolysis. Massive and submassive PEs were categorized into 2 groups depending on whether they were treated with LMWH or UFH after thrombolytic treatment. The primary end point was all-cause mortality during the first 30 days; the secondary end point included all-cause mortality, nonfatal symptomatic recurrent PEs, or nonfatal major bleeding. Results: The mean age at diagnosis was 60.7 15.5 years. The PE severity was massive in 186 (74.7%) patients and submassive in 63 (25.3%). The incidence of all-cause 30-day death was 8.2% and 17.3% in patients with LMWH and UFH, respectively (P = .031). Major hemorrhage occurred in 4% (n = 5) and 7.9% (n = 10) of patients and minor hemorrhage occurred in 9% (n = 11) and 13.4% (n = 17) of the cases treated with LMWH and UFH, respectively. Conclusion: These results suggest that LMWH treatment can be used safely in patients with PE after thrombolytic therapy.
Açıklama
Anahtar Kelimeler
Pulmonary Thromboembolism, Low-Molecular-Weight Heparin, Unfractionated Heparin
Kaynak
Clinical and Applied Thrombosis-Hemostasis
WoS Q Değeri
Q3
Scopus Q Değeri
Q2
Cilt
22
Sayı
4
