Direct oral anticoagulants are the recommended first-line therapy for acute pulmonary embolism, with thrombolysis reserved for hemodynamically unstable patients.
In the US, PE affects approximately 370 000 patients per year and may cause approximately 60 000 to 100 000 deaths per year. First-line therapy consists of direct oral anticoagulants such as apixaban, edoxaban, rivaroxaban, or dabigatran, with thrombolysis reserved for patients with systolic blood pressure lower than 90 mm Hg.
Freund et al. (Tue,) studied this question.
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