Why the study?
The use of thrombolytics in intermediate-high risk pulmonary embolism remains controversial.
Does half-dose alteplase improve mortality and clinical outcomes compared to LMWH in patients with intermediate-high risk pulmonary embolism?
Comparison
Half-dose alteplase (50 mg) vs anticoagulation with LMWH (enoxaparin)
Design
Single-center observational study with prospective and retrospective cohorts
Follow-up
One year
Key result
Half-dose alteplase did not significantly reduce one-month mortality (6.7% vs 15.8%, p=0.18) or one-year mortality compared to low molecular weight heparin in patients with intermediate-high risk pulmonary embolism.
Authors
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Half-dose alteplase may improve oxygenation without major bleeding in intermediate-high risk PE; leaves open mortality benefit pending randomized trials.
Observational (n=97)
No
Does half-dose alteplase improve mortality and clinical outcomes compared to LMWH in patients with intermediate-high risk pulmonary embolism?
Absolute Event Rate: 6.7% vs 15.8%
p-value: p=0.18
Half-dose alteplase significantly improved oxygenation and pulse rate without increasing major bleeding in intermediate-high risk pulmonary embolism, though it did not demonstrate a statistically significant mortality benefit compared to LMWH.
Unat et al. (2025) conducted an observational in Intermediate-high risk pulmonary embolism (n=97). Half-dose alteplase vs. Low molecular weight heparin (enoxaparin) was evaluated on One-month mortality (p=0.18). Half-dose alteplase did not significantly reduce one-month mortality (6.7% vs 15.8%, p=0.18) or one-year mortality compared to low molecular weight heparin in patients with intermediate-high risk pulmonary embolism.