AIM: The role of enoxaparin and weight-adjusted unfractionated heparin (UH) as adjunct to fibrinolytic therapy in pulmonary embolism is unknown. METHODS: In a prospective, open-label, controlled multicenter trial, 80 patients with high-risk pulmonary embolism were enrolled. Forty patients received alteplase infusion plus weight-adjusted UH (24-48 h) and then enoxaparin (7 days). In control group, UH standard regimen was used. There were not differences on pulmonary embolism extension, (P 0.63) and right ventricular hypokinesis (P 0.07) in both groups. In terms of in-hospital survival (P 0.009), escalation treatment (P < 0.001) and in-hospital stay (P < 0.001) study group had better outcome than opposite group. In a 30 (P < 0.001) and 90 (P < 0.001) days follow-up pulmonary perfusion was improved in patients who received enoxaparin versus heparin alone without increasing major bleeding complications. CONCLUSION:Enoxaparin and weight-adjusted intravenous UH as adjunct to 1-h alteplase infusion improve in-hospital and follow-up outcome compared to heparin alone in high-risk PE.
RCT Entities:
AIM: The role of enoxaparin and weight-adjusted unfractionated heparin (UH) as adjunct to fibrinolytic therapy in pulmonary embolism is unknown. METHODS: In a prospective, open-label, controlled multicenter trial, 80 patients with high-risk pulmonary embolism were enrolled. Forty patients received alteplase infusion plus weight-adjusted UH (24-48 h) and then enoxaparin (7 days). In control group, UH standard regimen was used. There were not differences on pulmonary embolism extension, (P 0.63) and right ventricular hypokinesis (P 0.07) in both groups. In terms of in-hospital survival (P 0.009), escalation treatment (P < 0.001) and in-hospital stay (P < 0.001) study group had better outcome than opposite group. In a 30 (P < 0.001) and 90 (P < 0.001) days follow-up pulmonary perfusion was improved in patients who received enoxaparin versus heparin alone without increasing major bleeding complications. CONCLUSION:Enoxaparin and weight-adjusted intravenous UH as adjunct to 1-h alteplase infusion improve in-hospital and follow-up outcome compared to heparin alone in high-risk PE.
Authors: Stefanos G Foussas; Michael N Zairis; Anastassios G Lyras; Nikolaos G Patsourakos; Vasilios G Tsirimpis; Kostas Katsaros; Demetrios J Beldekos; Stelios M Handanis; Demetrios Z Mytas; Kostas S Karidis; Paraskevi G Tselioti; Athanasios A Prekates; John A Ambrose Journal: Am J Cardiol Date: 2005-08-15 Impact factor: 2.778
Authors: C Jerjes-Sanchez; A Ramirez-Rivera; R Arriaga-Nava; S Iglesias-Gonzalez; P Gutierrez; C Ibarra-Perez; A Martinez; S Valencia; A Rosado-Buzzo; J A Pierzo; E Rosas Journal: J Thromb Thrombolysis Date: 2001-12 Impact factor: 2.300
Authors: Jiang-Shan Tan; Ningning Liu; Song Hu; Yan Wu; Xin Gao; Ting-Ting Guo; Xin-Xin Yan; Fu-Hua Peng; Lu Hua Journal: Front Cardiovasc Med Date: 2022-06-30