Key result
Alteplase infusion showed higher thrombolytic efficacy than bolus-dose alteplase (RR 1.95; 95% CI 1.19-3.2) and lower mortality due to initial PE than both bolus alteplase and streptokinase.
Why the study?
Do different thrombolytic regimens (alteplase infusion, bolus-dose alteplase, streptokinase) vary in efficacy and safety for the treatment of pulmonary embolism?
Population
Patients with pulmonary embolism (26 studies included in the analysis)
Comparison
Alteplase infusion, bolus-dose alteplase, or… vs Compared against each other
Design
Meta-analysis
Authors
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Alteplase infusion may reduce PE-related mortality versus bolus alteplase or streptokinase; leaves open confirmation by direct randomized trials.
Meta-Analysis
Do different thrombolytic regimens (alteplase infusion, bolus-dose alteplase, streptokinase) vary in efficacy and safety for the treatment of pulmonary embolism?
Relative Risk: 1.95 (95% CI 1.19–3.2)
Crude summated data suggests alteplase infusion may reduce PE-related mortality compared to bolus alteplase or streptokinase, but large-scale randomized controlled trials are needed due to a lack of direct comparative evidence.
Capstick et al. (2005) conducted a meta-analysis in massive pulmonary embolism (PE). Alteplase infusion vs. Bolus-dose alteplase or streptokinase was evaluated on Thrombolytic efficacy (RR 1.95, 95% CI 1.19-3.2). Alteplase infusion showed higher thrombolytic efficacy than bolus-dose alteplase (RR 1.95; 95% CI 1.19-3.2) and lower mortality due to initial PE than both bolus alteplase and streptokinase.