Articles producció científica> Medicina i Cirurgia

Treatment of Right Heart Thrombi Associated with Acute Pulmonary Embolism

  • Identification data

    Identifier: imarina:4682808
    Handle: https://hdl.handle.net/20.500.11797/imarina4682808
    Authors:
    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.
    Abstract:
    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 anticoagulati

  • Others:

    Author, as appears in the 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.
    Department: Medicina i Cirurgia
    URV's Author/s: Porras Ledantes, Jose Antonio
    Keywords: Treatment Thrombolysis Right heart thrombi Pulmonary embolism Anticoagulation thrombolysis right heart thrombi pulmonary embolism anticoagulation
    Abstract: 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.
    Thematic Areas: Saúde coletiva Medicine, general & internal Medicine (miscellaneous) Medicine (all) Medicina ii Medicina i General medicine
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 00029343
    Author's mail: joseantonio.porras@urv.cat
    Author identifier: 0000-0001-6418-1822
    Record's date: 2024-09-07
    Papper version: info:eu-repo/semantics/acceptedVersion
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: American Journal Of Medicine. 130 (5): 588-595
    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
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2017
    Publication Type: Journal Publications

  • Keywords:

    Medicine (Miscellaneous),Medicine, General & Internal
    Treatment
    Thrombolysis
    Right heart thrombi
    Pulmonary embolism
    Anticoagulation
    thrombolysis
    right heart thrombi
    pulmonary embolism
    anticoagulation
    Saúde coletiva
    Medicine, general & internal
    Medicine (miscellaneous)
    Medicine (all)
    Medicina ii
    Medicina i
    General medicine

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