Benefits / risks for fibrinolytic therapy in intermediate-risk PE

Benefits/Risks for fibrinolytic therapy in intermediate-risk PE

(HealthDay)—A single intravenous bolus of tenecteplase reduces early death and hemodynamic decompensation in normotensive patients with intermediate-risk pulmonary embolism, but increases the risk of major hemorrhage and stroke, according to a study published in the April 10 issue of the New England Journal of Medicine.

Guy Meyer, M.D., from the Hôpital Européen Georges Pompidou in Paris, and colleagues randomized 1,005 normotensive patients with intermediate-risk pulmonary embolism due to right ventricular dysfunction and myocardial injury to tenecteplase plus heparin or placebo plus heparin. A composite of death or hemodynamic decompensation (or collapse) within seven days of randomization marked the primary outcome.

The researchers found that death or hemodynamic decompensation occurred in 2.6 percent of the 506 patients in the tenecteplase group versus 5.6 percent of the 499 patients in the placebo group (odds ratio, 0.44; P = 0.02). Death occurred in the first seven days in six patients in the tenecteplase group and nine patients in the placebo group (P = 0.42). Extracranial bleeding occurred in 32 patients in the tenecteplase group and six patients in the (6.3 versus 1.2 percent; P < 0.001). In the tenecteplase group, 12 patients had a stroke (2.4 percent), of which 10 were hemorrhagic, compared to one patient with in the control group (P = 0.003).

"In patients with intermediate-risk pulmonary embolism, fibrinolytic therapy prevented hemodynamic decompensation but increased the risk of major hemorrhage and stroke," the authors write.

The study was funded in part by a grant from Boehringer Ingelheim.

More information: Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Clot-busting drug as effective as angioplasty

Mar 12, 2013

A clot-busting therapy may benefit some heart attack patients who cannot have immediate angioplasty, according to research presented today at the American College of Cardiology's 62nd Annual Scientific Session.

ASN: Bardoxolone methyl no benefit in T2DM, stage 4 CKD

Nov 11, 2013

(HealthDay)—Bardoxolone methyl does not reduce the risk of end-stage renal disease (ESRD) or cardiovascular death in patients with type 2 diabetes mellitus and stage 4 chronic kidney disease, according ...

Recommended for you

Most seniors eligible for statin Rx under new guidelines

Nov 25, 2014

(HealthDay)—Most older Americans qualify for treatment with statins under new guidelines for the treatment of blood cholesterol released late last year by the American College of Cardiology and the American ...

Asymptomatic atherosclerosis linked to cognitive impairment

Nov 25, 2014

In a study of nearly 2,000 adults, researchers found that a buildup of plaque in the body's major arteries was associated with mild cognitive impairment. Results of the study conducted at the University of Texas (UT) Southwestern ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.