Moderate Pulmonary Embolism Treated With Thrombolysis (from the “MOPETT“ Trial).


The role of low-dose thrombolysis in the reduction of pulmonary artery pressure in moderate pulmonary embolism (PE) has not been investigated. Because the lungs are very sensitive to thrombolysis, we postulated that effective and safe thrombolysis might be achieved by a lower dose of tissue plasminogen activator. The purpose of the present study was to evaluate the role of this “safe dose“ thrombolysis in the reduction of pulmonary artery pressure in moderate PE. During a 22-month period, 121 patients with moderate PE were randomized to receive a “safe dose“ of tissue plasminogen activator plus anticoagulation (thrombolysis group [TG], n = 61 patients) or anticoagulation alone (control group [CG], n = 60). The primary end points consisted of pulmonary hypertension and the composite end point of pulmonary hypertension and recurrent PE at 28 months. Pulmonary hypertension and the composite end point developed in 9 of 58 patients (16%) in the TG and 32 of 56 patients (57%) in the CG (p <0.001) and 9 of 58 patients (16%) in the TG and 35 of 56 patients (63%) in the CG (p <0.001), respectively. The secondary end points were total mortality, the duration of hospital stay, bleeding at the index hospitalization, recurrent PE, and the combination of mortality and recurrent PE. The duration of hospitalization was 2.2 +/- 0.5 days in the TG and 4.9 +/- 0.8 days in the CG (p <0.001). The combination of death plus recurrent PE was 1 (1.6%) in TG and 6 (10%) in the CG (p = 0.0489). No bleeding occurred in any group, and despite a positive trend in favor of a “safe dose“ thrombolysis, no significant difference was noted in the rate of individual outcomes of death and recurrent PE when assessed independently. In conclusion, the results from the present prospective randomized trial suggests that “safe dose“ thrombolysis is safe and effective in the treatment of moderate PE, with a significant immediate reduction in the pulmonary artery pressure that was maintained at 28 months.

Source:American Journal of cardiology

 

One thought on “Moderate Pulmonary Embolism Treated With Thrombolysis (from the “MOPETT“ Trial).

  1. It is strange but true that the exact Cause of Primary Pulmonary Hypertension is yet to be ascertained. However, researchers in this regard suggest that certain diet drugs (appetite suppressants) can make a person more prone to developing this fatal condition.Primary Pulmonary Hypertension is basically a disorder of the blood vessels wherein the pressure in the pulmonary artery rises above normal levels, thereby posing a life-threatening risk. Several diseases or causative factors, largely unknown, may lead to the malfunctioning denoted by the term Primary Pulmonary Hypertension.*

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