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Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis.

Marti C, John G, Konstantinides S, Combescure C, Sanchez O, Lankeit M, Meyer G, Perrier A - Eur. Heart J. (2014)

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.

View Article: PubMed Central - PubMed

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 christophe.marti@hcuge.ch.

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EHU218F1: Study flow chart.

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


Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis.

Marti C, John G, Konstantinides S, Combescure C, Sanchez O, Lankeit M, Meyer G, Perrier A - Eur. Heart J. (2014)

Study flow chart.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4352209&req=5

EHU218F1: Study flow chart.
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

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.

View Article: PubMed Central - PubMed

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 christophe.marti@hcuge.ch.

Show MeSH
Related in: MedlinePlus