Study
Intervention
Population
Conclusion
- Thrombolysis (tenecteplase 30-50mg & heparin) vs. no thrombolysis (placebo & heparin) in patients with intermediate-risk/sub-massive pulmonary embolism
- 1006 patients across 76 sites in 13 countries
- PE confirmed by V/Q, CT or pulmonary angiogram with RV dysfunction confirmed by echo or CT and raised troponin
- Primary outcome: Death or haemodynamic decompensation (composite endpoint) within 7 days significantly lower in thrombolysis group than placebo group (2.6%5.6%)
- Secondary outcomes:
- No significant difference in mortality (1.2% vs. 1.8%)
- Both major extracranial bleeding (6.3% vs. 1.2%) and haemorrhagic stroke (2% vs 0.2%) significantly higher in thrombolysis group
- Thrombolysis (tenecteplase & heparin) vs. no thrombolysis (heparin alone) in patients with intermediate-risk/sub-massive pulmonary embolism
- 83 patients across 8 sites in the USA
- PE confirmed by V/Q, CT or pulmonary angiogram with RV dysfunction confirmed by echo, troponin or BNP
- Composite primary outcome of death, intubation and major bleeding at 5 days or recurrent PE or impaired functional capacity at 90 days
- Significantly reduced adverse outcomes in thrombolysis group (15% vs. 37% had at least 1 adverse outcome)
- Thrombolysis with half standard dose thrombolysis (tPa & enoxaparin) vs. anticoagulation alone in 'moderate PE'
- 121 patients in single centre in the USA
- 'Moderate PE' defined as haemodynamically stable PE with >70% involvement of thrombus in ≥2 lobar or left or right main pulmonary arteries
- Primary outcome of development of pulmonary hypertension (pulmonary artery systolic pressure ≥ 40mmHg) significantly lower in thrombolysis group than control group(16% vs. 57%)