Point: Should Systemic Lytic Therapy Be Used for Submassive Pulmonary Embolism? Yes
Chest - Volume 143, Issue 2 (February 2013) - Copyright © 2013 The American College of Chest Physicians - About This Journal Remove Journals Issue Alert Add Journals Issue Alert
MDC Extra Article: This additional article is not currently cited in MEDLINE®, but was found in MD Consult's full-text literature database.
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Point/Counterpoint Editorials
Point: Should Systemic Lytic Therapy Be Used for Submassive Pulmonary Embolism? Yes
David Jiménez, MD, PhD*
Respiratory Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
* Correspondence to: David Jiménez, MD, PhD, Respiratory Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain
E-mail address: djc_69_98@yahoo.com
Financial/nonfinancial disclosures: The author has reported to CHEST the following conflict of interest: Dr Jiménez is a member of the Steering Committee of the Pulmonary Embolism International Thrombolysis Trial.Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.
PII S0012-3692(13)60072-0
DOI 10.1378/chest.12-2447
Abbreviations
BNP
brain natriuretic peptide
PE
pulmonary embolism
RV
right ventricular
Early mortality rates for pulmonary embolism (PE) range from 2.8 m/s, present in 68.8% of the enrolled patients) or RV dysfunction (defined as RV enlargement combined with loss of inspiratory collapse of the inferior vena cava, present in 31.2% of the enrolled patients) to receive IV recombinant tissue plasminogen activator, 100 mg over 2 h, followed by unfractionated heparin infusion, or placebo tissue plasminogen activator plus heparin anticoagulation. The study used in-hospital death or clinical deterioration requiring escalation of therapy (defined as catecholamine infusion,...