Key result
Thrombolysis did not significantly reduce mortality (2.7% vs 4.3%; RR 0.64; P=0.27) or recurrent PE compared with heparin alone in patients with submassive pulmonary embolism.
Why the study?
Does thrombolytic treatment reduce mortality or recurrent PE in adults with acute submassive pulmonary embolism compared to intravenous heparin alone?
Population
594 adults with acute submassive pulmonary embolism pooled from 7 prospective, randomized clinical trials.
Comparison
Thrombolytic treatment vs Intravenous heparin alone
Design
Meta-analysis
Authors
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Thrombolysis should not be routine in submassive PE; confirms heparin alone suffices and challenges broader lytic adoption.
Meta-Analysis (n=594)
Does thrombolytic treatment reduce mortality or recurrent PE in adults with acute submassive pulmonary embolism compared to intravenous heparin alone?
Relative Risk: 0.64 (95% CI 0.29–1.4)
Absolute Event Rate: 2.7% vs 4.3%
p-value: p=0.27
In patients with acute submassive pulmonary embolism, thrombolysis does not significantly reduce mortality or recurrent PE compared to heparin alone, but increases the risk of minor bleeding.
Cao et al. (2014) conducted a meta-analysis in submassive pulmonary embolism (PE) (n=594). Thrombolysis vs. Intravenous heparin was evaluated on Mortality (RR 0.64, 95% CI 0.29-1.40, p=0.27). Thrombolysis did not significantly reduce mortality (2.7% vs 4.3%; RR 0.64; P=0.27) or recurrent PE compared with heparin alone in patients with submassive pulmonary embolism.
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