Key result
Catheter-directed thrombolysis combined with anticoagulation significantly reduced 1-year mortality compared to anticoagulation alone (6.1% vs 11%; OR 0.51, 95% CI 0.35-0.76; p=0.0008).
Why the study?
Catheter-directed thrombolysis is a newer treatment option for submassive pulmonary embolism, motivating a comparison of its efficacy and safety combined with anticoagulation versus anticoagulation alone.
Does catheter-directed thrombolysis combined with anticoagulation reduce 1-year mortality in patients with submassive pulmonary embolism compared to anticoagulation alone?
Population
10595 patients with pulmonary embolism across 16 articles
Comparison
Catheter-directed thrombolysis combined with anticoagulation vs anticoagulation alone
Design
Systematic review and meta-analysis of 3 RCTs and 13 non-RCTs
Follow-up
1-year
Authors
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Supports CDT plus anticoagulation in eligible patients; confirms mortality benefit in Level 1 meta-analysis.
Meta-Analysis (n=10,595)
Does catheter-directed thrombolysis combined with anticoagulation reduce 1-year mortality in patients with submassive pulmonary embolism compared to anticoagulation alone?
Odds Ratio: 0.51 (95% CI 0.35–0.76)
Absolute Event Rate: 6.1% vs 11%
p-value: p=.0008
Catheter-directed thrombolysis combined with anticoagulation significantly reduces short- and long-term mortality in patients with submassive pulmonary embolism compared to anticoagulation alone, though with an increased risk of minor bleeding.
Sun et al. (2023) conducted a meta-analysis in pulmonary embolism (n=10,595). Catheter-directed thrombolysis (CDT) combined with anticoagulation vs. Anticoagulation alone (AC) was evaluated on 1-year mortality (OR 0.51, 95% CI 0.35-0.76, p=.0008). Catheter-directed thrombolysis combined with anticoagulation significantly reduced 1-year mortality compared to anticoagulation alone (6.1% vs 11%; OR 0.51, 95% CI 0.35-0.76; p=0.0008).
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