0
Pulmonary Vascular Disease |

Efficacy and Safety of Thrombolysis in Pulmonary Embolism: A Meta-analysis FREE TO VIEW

Adil Shujaat; Abubakr Bajwa
Author and Funding Information

University of Florida, Jacksonville, FL


Chest. 2014;146(4_MeetingAbstracts):831A. doi:10.1378/chest.1995123
Text Size: A A A
Published online

Abstract

SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Previous meta-analyses of randomized clinical trials (RCT) of thrombolysis compared with heparin for the treatment of pulmonary embolism (PE) have been under-powered to detect a difference in mortality. The recent announcement of the results of PEITHO, the largest ever RCT of thrombolysis compared with heparin in PE, warrants an updated meta-analysis.

METHODS: We searched for prospective, randomized, placebo controlled, clinical trials of thrombolysis compared with heparin for the treatment of PE in PUBMED, among reference lists of the initially identified articles, and among abstracts presented at international scientific meetings. Outcomes of interest were mortality and major bleeding, including intracranial bleeding. We used fixed effects model to perform the meta-analysis.

RESULTS: Fifteen RCTs involving 1966 patients were included. Thrombolysis compared with heparin was associated with a significant reduction in death (2.3% versus 3.97%; OR 0.59, 95% CI 0.36 to 0.97; number needed to treat: 62) and a significant increase in major bleeding (8.3% versus 3.6%; OR 2.37, 95%CI 1.58 to 3.55; number needed to harm: 21).

CONCLUSIONS: Thrombolysis compared with heparin for initial treatment in patients with PE reduces mortality but such benefit is outweighed by risk of major bleeding.

CLINICAL IMPLICATIONS: Thrombolysis can not be recommended for initial treatment in unselected patients with PE.

DISCLOSURE: The following authors have nothing to disclose: Adil Shujaat, Abubakr Bajwa

No Product/Research Disclosure Information


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
Guidelines on use of vena cava filters.
British Committee for Standards in Haematology | 9/25/2009
Guidelines on the use and monitoring of heparin.
British Committee for Standards in Haematology | 9/25/2009
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543