Assessment of Lytic Therapy Effect in Patients with Intermediate-high Risk Pulmonary Embolism for Prevention of Chronic Thromboembolic Pulmonary Hypertension: A Randomized, Double-blind Trial

Overview

Journal Health Sci Rep

Specialty General Medicine

Date 2024 Jun 12

PMID 38863732

Authors

Pejman Mansouri

Amir Mohsen Rashidi

Mohammad Hadi Mansouri

Masoumeh Sadeghi

Reihaneh Zavar

Afshin Amirpour

Seyedeh Melika Hashemi

Marzieh Taheri

Affiliations

Soon will be listed here.

Abstract

Background And Aims: This study aims to compare the effectiveness of thrombolytic therapy and anticoagulation in preventing chronic thromboembolic pulmonary hypertension (CTEPH).

Method: A total of 60 patients with intermediate-high risk pulmonary embolism (PE) were randomly assigned to receive either thrombolytic therapy ( = 30) or anticoagulation ( = 30).

Results: Echocardiographic assessments demonstrated no significant differences between the two treatment approaches in terms of right ventricular size (RVS) (on discharge in thrombolytic group: 31.17 ± 3.43 vs. anticoagulant group: 32.73 ± 5.27, = 0.912), tricuspid annular plane systolic excursion (TAPSE) (on discharge in thrombolytic group: 17.66 ± 2.39 vs. anticoagulant group: 16.73 ± 2.93, = 0.290), and systolic pulmonary artery pressure (SPAP) (on discharge in thrombolytic group: 32.93 ± 9.73 vs. anticoagulant group: 34.46 ± 9.30, = 0.840). However, significant changes were observed in all assessed parameters within each treatment group ( < 0.001). The 6-month follow-up showed no significant difference between the two groups in terms of CTEPH incidence ( = 0.781) or functional class of the patients ( = 0.135).

Conclusion: Based on the findings of this study, neither thrombolytic therapy nor anticoagulation demonstrated superiority over the other in reducing adverse outcomes associated with intermediate-high risk PE, including right ventricular size, SPAP, TAPSE, or CTEPH.

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