Comparison of catheter-directed thrombolysis and anticoagulation in intermediate-risk pulmonary embolism: A retrospective analysis
| dc.authorid | 0000-0003-2995-8792 | |
| dc.contributor.author | Özden Omaygenç, Derya | |
| dc.contributor.author | Omaygenç, Mehmet Onur | |
| dc.date.accessioned | 2021-05-27T11:36:22Z | |
| dc.date.available | 2021-05-27T11:36:22Z | |
| dc.date.issued | 2021 | |
| dc.department | İstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı | |
| dc.description.abstract | BACKGROUND AND OBJECTIVES: The selection of escalation of care strategies for the treatment of intermediate-risk pulmonary embolism (PE) is a matter of debate. Here, we aimed to assess the features of our population treated either with anticoagulation (AC) alone or catheter-directed thrombolysis (CDT). We also sought to identify a relationship between high residual systolic pulmonary artery pressure (sPAP) and demographic and clinical variables. PATIENTS AND METHODS: The retrospective data of 30 intermediate-high-risk PE patients were analyzed. CDT was used in 14 (46.7%) cases. Enoxaparin (b. i. d) injections were administered in the AC group. In the CDT group, patients received 5 mg bolus dose of alteplase followed by 1 mg/h infusion for 24 h. Estimated sPAP at presentation and discharge was recorded. A value equal to or greater than 40 mmHg in the latter was accepted as a significant rise. RESULTS: The patients in the CDT group had a lower HAS-BLED score (2 [0-3] vs. 1 [0-3], P = 0.03). Although initial sPAP values were comparable among treatment arms, sPAP at discharge was significantly lower in the CDT group (mmHg, 42 +/- 11.2 vs. 33.6 +/- 9.7, P = 0.04). The reduction in sPAP at discharge was also significantly higher in this group. The degree of reduction in sPAP was considerably correlated with baseline sPAP (r: 63.2, P < 0.001). Finally, the baseline sPAP measurement and HAS-BLED score of the patients with high residual sPAP were significantly higher (56.6 +/- 13.1 vs. 67.3 +/- 11.3, P = 0.02, and 1 [0-3] vs. 2 [0-3], P = 0.02, respectively). CONCLUSION: CDT was preferred over AC when lower bleeding risk was anticipated for intermediate-high-risk PE patients in our sample population. Eventually, CDT provided lower discharge sPAP levels and a greater reduction in sPAP. However, the factors associated with high sPAP at discharge were only high baseline sPAP measurement and HAS-BLED score. | |
| dc.identifier.citation | Özden Omaygenç, D. ve Omaygenç, M. O. (2021). Comparison of catheter-directed thrombolysis and anticoagulation in intermediate-risk pulmonary embolism: A retrospective analysis. Eurasian Journal of Pulmonology, 23(1), 50-58. https://dx.doi.org/10.4103/ejop.ejop_73_20 | |
| dc.identifier.doi | 10.4103/ejop.ejop_73_20 | |
| dc.identifier.endpage | 58 | |
| dc.identifier.issn | 2148-3620 | |
| dc.identifier.issn | 2148-5402 | |
| dc.identifier.issue | 1 | |
| dc.identifier.startpage | 50 | |
| dc.identifier.uri | https://dx.doi.org/10.4103/ejop.ejop_73_20 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.12511/6952 | |
| dc.identifier.volume | 23 | |
| dc.identifier.wosquality | N/A | |
| dc.indekslendigikaynak | Web of Science | |
| dc.language.iso | en | |
| dc.publisher | Wolters Kluwer Medknow Publications | |
| dc.relation.ispartof | Eurasian Journal of Pulmonology | en_US |
| dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | |
| dc.rights | Attribution-NonCommercial-ShareAlike 4.0 International | * |
| dc.rights | info:eu-repo/semantics/openAccess | |
| dc.rights.uri | https://creativecommons.org/licenses/by-nc-sa/4.0/ | * |
| dc.subject | Anticoagulants | |
| dc.subject | Pulmonary Embolism | |
| dc.subject | Pulmonary Hypertension | |
| dc.subject | Thrombolytic Therapy | |
| dc.title | Comparison of catheter-directed thrombolysis and anticoagulation in intermediate-risk pulmonary embolism: A retrospective analysis | |
| dc.type | Article |
