The introduction of NOACs and improved diagnostic techniques have positively impacted the management and outcomes of patients with pulmonary embolism.
May inform current PE management strategies; leaves open need for prospective trials to confirm causality.
Pulmonary embolism (PE) is the key potentially reversible cause of in-hospital mortality. To help the practitioner, leading experts in different countries are developing and updating guidelines which analyze and generalize approaches to the treatment of PE. Recently, among the factors leading to positive dynamics in outcomes of patients with PE (according to the RIETE registry),the researchers have considered improvement of diagnostic techniques as well as technical improvements in tomographic scanners. Another reason for improved outcomes of treated patients with deep vein thrombosis and pulmonary embolism is optimization of anticoagulation therapy. The emergence of “new” oral anticoagulants (NOAC: rivaroxaban, dabigatran, apixaban) marked the beginning of a qualitatively new approach to the treatment of PE characterized by convenience of treatment without the need for regular monitoring of blood coagulation parameters. In addition to the emergence of new convenient and effective drugs, the approach to diagnosis and treatment of patients also changed, as reflected in the updated guidelines for the management of patients with venous thromboembolic complications (ESC 2014, ACCP 2016).
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Gilyarov et al. (2017) studied this question.
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