Clot-busters safe for treating moderate pulmonary embolism
Pulmonary embolism -- the sudden blockage of an artery in the lung -- is estimated to cause over 100,000 deaths each year in the U.S. Although thrombolytics, or "clot-buster" drugs, are currently reserved to treat only the most severe cases of pulmonary embolism, new data suggest that when used at lower doses, these drugs are also safe and effective for more common, moderate cases of pulmonary embolism, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.
Researchers found that using half the usual dose of the thrombolytic drug tissue plasminogen activator (t-PA) not only effectively dissolved clots in patients with moderate pulmonary embolism, but also led to earlier hospital discharge and reduced the rate of pulmonary hypertension and recurrent pulmonary embolism without causing bleeding or other major side effects.
Currently, only about 5 percent of pulmonary embolism cases are considered severe enough to be given thrombolytic agents at full dose. While these drugs are effective in dissolving blood clots, they carry a 2 percent to 6 percent risk of causing dangerous bleeding inside the brain. The vast majority of pulmonary embolism cases are considered moderate, and thus are typically treated with anticoagulants (anti-clotting agents). However, even moderate cases can lead to recurring pulmonary embolism, pulmonary hypertension and other dangerous complications.
"Pulmonary embolism can be more aggressively and above all, safely managed with what we call 'safe-dose thrombolysis,'" said Mohsen Sharifi, MD, director of Arizona Cardiovascular Consultants and the study's lead investigator. "Eighty percent, or more, of pulmonary embolism patients would benefit from this treatment."
Other research has investigated the use of thrombolytics for moderate pulmonary embolism, but this is the first study to show that using a lower dose of t-PA and anticoagulants can be safe and effective for such patients. These findings could ultimately change the way doctors handle hundreds of thousands of cases each year.
Pulmonary embolism, a complication of deep vein thrombosis, occurs when a blood clot becomes lodged in a lung artery after traveling there from elsewhere in the body, typically the legs. It can lead to death if left untreated.
Dr. Sharifi said expanding the use of "safe-dose thrombolysis" to more aggressively treat moderate pulmonary embolism could help prevent patients from developing more serious complications later on. He further emphasized the need to lower the dose of anticoagulants given along with t-PA.
"Moderate pulmonary embolism may be the tip of the iceberg," said Dr. Sharifi. "These patients might be doing okay initially, but ultimately, in the subsequent few years, they may develop complications."
The study enrolled 121 patients with moderate pulmonary embolism and gave 61 of them a half-dose of thrombolytic drugs with a modified regimen of anticoagulants. Sixty were given anticoagulants alone. Patients were tracked for 28 months.
In addition to treating severe pulmonary embolism, thrombolysis is commonly used to dissolve the blood clots that cause heart attacks and strokes.
More information: Dr. Sharifi will present the study "Moderate Pulmonary Embolism Treated with Thrombolysis (MOPETT Study)" on Tuesday, March 27 at 8 a.m. during the Joint ACC/JAMA Late-Breaking Clinical Trials in McCormick Place North: Main Tent.
Provided by American College of Cardiology
- 'Clot-busters' no more effective than traditional therapy in treating lung blood clots May 16, 2011 | not rated yet | 0
- Risk of pulmonary embolism greatest during first week following total joint replacement Feb 07, 2012 | not rated yet | 0
- Are blood thinners post-op killers? Mar 31, 2008 | not rated yet | 0
- Clearing the way for detecting pulmonary embolism Dec 01, 2009 | not rated yet | 0
- Consider the breast and lungs when determining thoracic imaging protocols Oct 01, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Indeterminism in Classical Physics
3 hours ago I was reading the Roger Penrose book Emperor's New Mind and he was explaining the determinism in Newtonian mechanics. He says that if we consider...
Current in two wires
4 hours ago Wire A and B, which have the same cross-sectional area are connected in series. There is a p.d. V across the whole wire. Suppose the two wires...
understanding the dipole model for Rayleigh scattering
6 hours ago Hello. I am currently studying scattering theory in detail for my BSc thesis, and I'm starting with Rayleigh scattering. I'm following Scattering...
question on coriolis effect with drag force
12 hours ago I really need help with this question. A small floating object initially moves with velocity v on the surface of a liquid at latitude λ. The...
Question of reflection and transmission of TEM wave in normal incidenc
17 hours ago Suppose TEM wave in +z normal to a boundary on xy plane at z=0. We know *E* & *H* are tangential to the boundary. Let ##\vec E_i=\hat x E##, be the...
the rudyak-krasnolutski effective potencial
18 hours ago Hi ... anyone now how to calculate or the formula of the rudyak-krasnolutski EFFECTIVE potencial ? the effective potencial includes the angular...
- More from Physics Forums - Classical Physics
More news stories
Routinely measuring fractional flow reserve (FFR) using pressure wire assessment during coronary angiography for diagnosis of chest pain leads to significant changes in the management of one in four patients, according to ...
Cardiology 1 hour ago | not rated yet | 0
A new investigational device - the Helio System (TF-FA) - being developed for use with the Sapien XT Transcatheter Heart Valve was successfully deployed in all four patients in a small, first-in-human feasibility study of ...
Cardiology 1 hour ago | not rated yet | 0
Cardiac study used as source for new guidelines on treating people undergoing coronary artery bypass surgery
Cardiac research from the University of Alberta had serious impact as a source for the American College of Cardiology and the American Heart Association's new guidelines on how to treat patients undergoing coronary artery ...
Cardiology 2 hours ago | not rated yet | 0
(HealthDay)—In patients who have previously been considered difficult to image, dual-source cardiac (DSC) computed tomography (CT) can identify clinically significant coronary artery disease, according ...
Cardiology 16 hours ago | not rated yet | 0
UCLA researchers examining outcomes for advanced heart-failure patients over the past two decades have found that, coinciding with the increased availability and use of new therapies, overall mortality has decreased and sudden ...
Cardiology 18 hours ago | not rated yet | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
1 hour ago | not rated yet | 0
New research presented today shows that formation of new neurons in the hippocampus - a brain region known for its importance in learning and remembering - could cause forgetting of old memories by causing a reorganization ...
57 minutes ago | not rated yet | 0
Ernie Pyle – an iconic war correspondent in World War II – reportedly said "There are no atheists in foxholes." A new joint study between two brothers at Cornell and Virginia Wesleyan found that only ...
1 hour ago | not rated yet | 0
Saudi Arabia said Friday it would send samples taken from animals possibly infected with a deadly SARS-like virus to the United States for testing in a bid to find the source of disease.
37 minutes ago | not rated yet | 0
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
1 hour ago | not rated yet | 0 |