Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis.
Bottom Line: Thrombolytic therapy was associated with a significant reduction in the combined endpoint of death or treatment escalation (OR: 0.34, 95% CI: 0.22-0.53), PE-related mortality (OR: 0.29; 95% CI: 0.14-0.60) and PE recurrence (OR: 0.50; 95% CI: 0.27-0.94).The decrease in overall mortality is, however, not significant in haemodynamically stable patients with acute PE.Thrombolytic therapy is associated with an increase of major and fatal or intracranial haemorrhage.
Affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and Geneva Faculty of Medicine, Rue Gabrielle Perret-Gentil 4, 1211 Geneva 14, Switzerland email@example.com.Show MeSH
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Mentions: The search retrieved a total of 4338 references, among which 940 duplicates were identified. Of the 3398 remaining articles, 3169 were excluded based on title and abstract (Figure 1). Full-text was obtained for the remaining 229 articles. Of these, 29 did not contain original data, 58 did not study systemic thrombolysis, 96 were non-randomized trials, 33 compared two thrombolytic regimens, and 13 satisfied the inclusion criteria. Two additional studies were identified by manual search.19,26 Inter-readers agreement was high (Kappa coefficient 0.99). The main characteristics of the included studies are displayed in Table 1.Table 1
Affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and Geneva Faculty of Medicine, Rue Gabrielle Perret-Gentil 4, 1211 Geneva 14, Switzerland firstname.lastname@example.org.