Key result
Low-molecular-weight heparin significantly reduced the risk of major bleeding (OR 0.41; 95% CI 0.17-0.97; P=0.04) and 30-day mortality compared to unfractionated heparin postthrombolysis.
Why the study?
LMWH is proven for VTE treatment, but its use around thrombolysis remains controversial compared to UFH.
Does low-molecular-weight heparin reduce VTE recurrence, bleeding complications, and 30-day mortality compared to unfractionated heparin in patients with massive and submassive pulmonary embolism postthrombolysis?
Comparison
LMWH (227 patients) vs UFH (299 patients)
Design
Systematic review and meta-analysis of 1 RCT, 1 prospective, and 1 retrospective study
Authors
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May support LMWH over UFH postthrombolysis in massive/submassive PE; extends meta-analytic evidence to this high-risk setting.
Meta-Analysis (n=526)
Does low-molecular-weight heparin reduce VTE recurrence, bleeding complications, and 30-day mortality compared to unfractionated heparin in patients with massive and submassive pulmonary embolism postthrombolysis?
Odds Ratio: 0.41 (95% CI 0.17–0.97)
p-value: p=0.04
In patients with massive and submassive PE postthrombolysis, LMWH is associated with lower risks of major bleeding and 30-day mortality compared to UFH, though evidence is limited.
Mansory et al. (2024) conducted a meta-analysis in Massive and submissive pulmonary embolism (PE) in the acute postthrombolysis phase (n=526). Low-molecular-weight heparin (LMWH) vs. Unfractionated heparin (UFH) was evaluated on Major bleeding (OR 0.41, 95% CI 0.17-0.97, p=0.04). Low-molecular-weight heparin significantly reduced the risk of major bleeding (OR 0.41; 95% CI 0.17-0.97; P=0.04) and 30-day mortality compared to unfractionated heparin postthrombolysis.
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