Articles producció científica> Medicina i Cirurgia

Treatment of Right Heart Thrombi Associated with Acute Pulmonary Embolism

  • Datos identificativos

    Identificador: imarina:4682808
    Autores:
    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.
    Resumen:
    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
  • Otros:

    Autor según el artículo: 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.
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: Porras Ledantes, Jose Antonio
    Palabras clave: Treatment Thrombolysis Right heart thrombi Pulmonary embolism Anticoagulation thrombolysis right heart thrombi pulmonary embolism anticoagulation
    Resumen: 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.
    Áreas temáticas: Saúde coletiva Medicine, general & internal Medicine (miscellaneous) Medicine (all) Medicina ii Medicina i General medicine
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 00029343
    Direcció de correo del autor: joseantonio.porras@urv.cat
    Identificador del autor: 0000-0001-6418-1822
    Fecha de alta del registro: 2024-09-07
    Versión del articulo depositado: info:eu-repo/semantics/acceptedVersion
    Enlace a la fuente original: https://www.amjmed.com/article/S0002-9343(16)31241-4/fulltext
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: American Journal Of Medicine. 130 (5): 588-595
    Referencia 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 del artículo: 10.1016/j.amjmed.2016.11.027
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2017
    Tipo de publicación: Journal Publications
  • Palabras clave:

    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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