Autor segons l'article: Barrios D., Chavant J., Jiménez D., Bertoletti L., Rosa-Salazar V., Muriel A., Viallon A., Fernández-Capitán C., Yusen R.D., Monreal M., Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Tzoran I., Reis A., Bosevski M., Bounameaux H., Malý R., Wells P., Verhamme P., Adarraga M.D., Aibar M.A., Alfonso M., Arcelus J.I., Azcarate-Agüero P.M., Ballaz A., Barrón M., Barrón-Andrés B., Bascuñana J., Blanco-Molina A., Cañada G., Cañas I., Casado I., Chic N., del Pozo R., del Toro J., Díaz-Pedroche M.C., Díaz-Peromingo J.A., Barrios D., Chavant J., Jiménez D., Bertoletti L., Rosa-Salazar V., Muriel A., Viallon A., Fernández-Capitán C., Yusen R.D., Monreal M., Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Tzoran I., Reis A., Bosevski M., Bounameaux H., Malý R., Wells P., Verhamme P., Adarraga M.D., Aibar M.A., Alfonso M., Arcelus J.I., Azcarate-Agüero P.M., Ballaz A., Barrón M., Barrón-Andrés B., Bascuñana J., Blanco-Molina A., Cañada G., Cañas I., Casado I., Chic N., del Pozo R., del Toro J., Díaz-Pedroche M.C., Díaz-Peromingo J.A., Barrios D., Chavant J., Jiménez D., Bertoletti L., Rosa-Salazar V., Muriel A., Viallon A., Fernández-Capitán C., Yusen R.D., Monreal M., Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Tzoran I., Reis A., Bosevski M., Bounameaux H., Malý R.
Departament: Medicina i Cirurgia
Autor/s de la URV: Porras Ledantes, Jose Antonio
Paraules clau: Treatment Thrombolysis Right heart thrombi Pulmonary embolism Anticoagulation thrombolysis right heart thrombi pulmonary embolism anticoagulation
Resum: Background Evidence-based recommendations do not adequately address the treatment of right heart thrombi in patients who present with acute symptomatic pulmonary embolism. Methods This study included patients who had acute pulmonary embolism associated with right heart thrombi and participated in the Registro Informatizado de la Enfermedad TromboEmbólica registry. We assessed the effectiveness of anticoagulation versus reperfusion treatment for the outcomes of all-cause mortality, pulmonary embolism-related mortality, recurrent venous thromboembolism, and major bleeding rates through 30 days after initiation of pulmonary embolism treatment. We used propensity score matching to adjust for the likelihood of receiving reperfusion treatment. Results Of 325 patients with pulmonary embolism and right heart thrombi, 255 (78%; 95% confidence interval, 74-83) received anticoagulation and 70 (22%; 95% confidence interval, 17-26) also received reperfusion treatment. Propensity score-matched pairs analyses did not detect a statistically lower risk of all-cause death (6.2% vs 14%, P = .15) or pulmonary embolism-related mortality (4.7% vs 7.8%; P = .47) for reperfusion compared with anticoagulation. Of the patients who received reperfusion treatment, 6.2% had a recurrence during the study follow-up period, compared with 0% of those who received anticoagulation (P = .049). The incidence of major bleeding events was not statistically different between the 2 treatment groups (3.1% vs 3.1%; P = 1.00). Conclusions In patients with pulmonary embolism and right heart thrombi, no significant difference was found between reperfusion therapy and anticoagulant therapy for mortality and bleeding. The risk of recurrences was significantly higher for reperfusion therapy compared with anticoagulation. Right heart thrombi may not warrant riskier interventions than standard anticoagulation.
Àrees temàtiques: Saúde coletiva Medicine, general & internal Medicine (miscellaneous) Medicine (all) Medicina ii Medicina i General medicine
Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
ISSN: 00029343
Adreça de correu electrònic de l'autor: joseantonio.porras@urv.cat
Identificador de l'autor: 0000-0001-6418-1822
Data d'alta del registre: 2024-09-07
Versió de l'article dipositat: info:eu-repo/semantics/acceptedVersion
Enllaç font original: https://www.amjmed.com/article/S0002-9343(16)31241-4/fulltext
URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
Referència a l'article segons font original: American Journal Of Medicine. 130 (5): 588-595
Referència de l'ítem segons les normes APA: Barrios D., Chavant J., Jiménez D., Bertoletti L., Rosa-Salazar V., Muriel A., Viallon A., Fernández-Capitán C., Yusen R.D., Monreal M., Decousus H., (2017). Treatment of Right Heart Thrombi Associated with Acute Pulmonary Embolism. American Journal Of Medicine, 130(5), 588-595. DOI: 10.1016/j.amjmed.2016.11.027
DOI de l'article: 10.1016/j.amjmed.2016.11.027
Entitat: Universitat Rovira i Virgili
Any de publicació de la revista: 2017
Tipus de publicació: Journal Publications
Repositori URV