Loading…
Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis
Background: The outcomes of thrombolytic therapy (TT) in elderly patients with prosthetic valve thrombosis (PVT) have not been evaluated previously. We investigated the outcomes of low-dose and slow infusion TT strategies in elderly patients with PVT. Methods: Twenty-seven (19 female) patients aged...
Saved in:
Published in: | Clinical and applied thrombosis/hemostasis 2017-04, Vol.23 (3), p.241-247 |
---|---|
Main Authors: | , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Request full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c407t-a0fc0f984c94ef7a9c869318008a380b3cf28bf2eda8f11b7bef19b1a368960a3 |
---|---|
cites | cdi_FETCH-LOGICAL-c407t-a0fc0f984c94ef7a9c869318008a380b3cf28bf2eda8f11b7bef19b1a368960a3 |
container_end_page | 247 |
container_issue | 3 |
container_start_page | 241 |
container_title | Clinical and applied thrombosis/hemostasis |
container_volume | 23 |
creator | Gündüz, Sabahattin Özkan, Mehmet Yesin, Mahmut Kalçık, Macit Gürsoy, Mustafa Ozan Karakoyun, Süleyman Astarcıoğlu, Mehmet Ali Aykan, Ahmet Çağrı Gökdeniz, Tayyar Biteker, Murat Duran, Nilüfer Ekşi Yıldız, Mustafa |
description | Background:
The outcomes of thrombolytic therapy (TT) in elderly patients with prosthetic valve thrombosis (PVT) have not been evaluated previously. We investigated the outcomes of low-dose and slow infusion TT strategies in elderly patients with PVT.
Methods:
Twenty-seven (19 female) patients aged ≥65 years (median: 70 years, range: 65-82 years) were treated with repeated TT agents for PVT. The TT regimens included 24-hour infusion of 1.5 million units of streptokinase in 2 patients, 6-hour infusion of 25 mg recombinant tissue plasminogen activator (t-PA) in 12 patients, and 25-hour infusion of 25 mg t-PA in 13 patients. Treatment success and adverse event rates were assessed.
Results:
The initial and cumulative success rates were 40.7% and 85.2%, respectively. Adverse events occurred in 6 (22.2%) patients including 4 (14.8%) major (1 death, 1 rethrombosis, and 2 failed TT) and 2 (7.4%) minor (1 transient ischemic attack and 1 access site hematoma) events. Higher thrombus burden (thrombus area ≥1.1 cm2 by receiver operating characteristics analysis, sensitivity: 83.3%, specificity: 85%, area under the curve: 0.86, P = .008) and New York Heart Association class (0% vs 15.4% vs 25% vs 100% for classes I-IV, respectively, P = .02) predicted adverse events. By multiple variable analysis, thrombus area was the only independent predictor of adverse events (odds ratio: 13.8, 95% confidence interval: 1.02-185, P = .04).
Conclusion:
Slow infusion of low doses of TT agents (mostly t-PA) with repetition is successful and safe in elderly patients with PVT. However, excessive thrombus burden may predict adverse events. |
doi_str_mv | 10.1177/1076029615609698 |
format | article |
fullrecord | <record><control><sourceid>proquest_AFRWT</sourceid><recordid>TN_cdi_proquest_journals_2344185411</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_1076029615609698</sage_id><sourcerecordid>2344185411</sourcerecordid><originalsourceid>FETCH-LOGICAL-c407t-a0fc0f984c94ef7a9c869318008a380b3cf28bf2eda8f11b7bef19b1a368960a3</originalsourceid><addsrcrecordid>eNp1kMFLwzAUxoMobk7vniTguZrXdGlylDndYOAOU48lbZO1o2tmkir7783YnCB4eg_e7_u-x4fQNZA7gDS9B5IyEgsGQ0YEE_wE9UFQHsVpTE_DHs7R7t5DF86tCIEAsXPUi1mSpCBEH1VzaxrTLlWJp63uXG1ah43GM_MVPRqn8KKyZp2bZuvrwuG6xeOmVLbZ4rn0tWq9w--1r3Cwcb5SAcITJa3Hb7L5PKpd7S7RmZaNU1eHOUCvT-PFaBLNXp6no4dZVCQk9ZEkuiBa8KQQidKpFAVnggInhEvKSU4LHfNcx6qUXAPkaa40iBwkZVwwIukA3e59N9Z8dMr5bGU624bILKZJAnyYAASK7Kki_O2s0tnG1mtptxmQbFdt9rfaILk5GHf5WpVHwU-XAYj2gJNL9Zv6r-E37H6Bkg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2344185411</pqid></control><display><type>article</type><title>Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis</title><source>Sage Journals GOLD Open Access 2024</source><creator>Gündüz, Sabahattin ; Özkan, Mehmet ; Yesin, Mahmut ; Kalçık, Macit ; Gürsoy, Mustafa Ozan ; Karakoyun, Süleyman ; Astarcıoğlu, Mehmet Ali ; Aykan, Ahmet Çağrı ; Gökdeniz, Tayyar ; Biteker, Murat ; Duran, Nilüfer Ekşi ; Yıldız, Mustafa</creator><creatorcontrib>Gündüz, Sabahattin ; Özkan, Mehmet ; Yesin, Mahmut ; Kalçık, Macit ; Gürsoy, Mustafa Ozan ; Karakoyun, Süleyman ; Astarcıoğlu, Mehmet Ali ; Aykan, Ahmet Çağrı ; Gökdeniz, Tayyar ; Biteker, Murat ; Duran, Nilüfer Ekşi ; Yıldız, Mustafa</creatorcontrib><description>Background:
The outcomes of thrombolytic therapy (TT) in elderly patients with prosthetic valve thrombosis (PVT) have not been evaluated previously. We investigated the outcomes of low-dose and slow infusion TT strategies in elderly patients with PVT.
Methods:
Twenty-seven (19 female) patients aged ≥65 years (median: 70 years, range: 65-82 years) were treated with repeated TT agents for PVT. The TT regimens included 24-hour infusion of 1.5 million units of streptokinase in 2 patients, 6-hour infusion of 25 mg recombinant tissue plasminogen activator (t-PA) in 12 patients, and 25-hour infusion of 25 mg t-PA in 13 patients. Treatment success and adverse event rates were assessed.
Results:
The initial and cumulative success rates were 40.7% and 85.2%, respectively. Adverse events occurred in 6 (22.2%) patients including 4 (14.8%) major (1 death, 1 rethrombosis, and 2 failed TT) and 2 (7.4%) minor (1 transient ischemic attack and 1 access site hematoma) events. Higher thrombus burden (thrombus area ≥1.1 cm2 by receiver operating characteristics analysis, sensitivity: 83.3%, specificity: 85%, area under the curve: 0.86, P = .008) and New York Heart Association class (0% vs 15.4% vs 25% vs 100% for classes I-IV, respectively, P = .02) predicted adverse events. By multiple variable analysis, thrombus area was the only independent predictor of adverse events (odds ratio: 13.8, 95% confidence interval: 1.02-185, P = .04).
Conclusion:
Slow infusion of low doses of TT agents (mostly t-PA) with repetition is successful and safe in elderly patients with PVT. However, excessive thrombus burden may predict adverse events.</description><identifier>ISSN: 1076-0296</identifier><identifier>EISSN: 1938-2723</identifier><identifier>DOI: 10.1177/1076029615609698</identifier><identifier>PMID: 26447199</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Blood clots ; Dose-Response Relationship, Drug ; Drug Evaluation ; Female ; Fibrinolytic Agents - administration & dosage ; Fibrinolytic Agents - adverse effects ; Heart Valve Prosthesis - adverse effects ; Humans ; Male ; Predictive Value of Tests ; Prostheses ; Streptokinase - administration & dosage ; Thrombolytic Therapy - adverse effects ; Thrombolytic Therapy - methods ; Thrombosis ; Thrombosis - drug therapy ; Thrombosis - etiology ; Thrombosis - pathology ; Tissue Plasminogen Activator - administration & dosage</subject><ispartof>Clinical and applied thrombosis/hemostasis, 2017-04, Vol.23 (3), p.241-247</ispartof><rights>The Author(s) 2015</rights><rights>The Author(s) 2015. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at: https://uk.sagepub.com/en-gb/eur/reusing-open-access-and-sage-choice-content</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-a0fc0f984c94ef7a9c869318008a380b3cf28bf2eda8f11b7bef19b1a368960a3</citedby><cites>FETCH-LOGICAL-c407t-a0fc0f984c94ef7a9c869318008a380b3cf28bf2eda8f11b7bef19b1a368960a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1076029615609698$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2344185411?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,21966,25753,27853,27924,27925,37012,44590,44945,45333</link.rule.ids><linktorsrc>$$Uhttps://journals.sagepub.com/doi/full/10.1177/1076029615609698?utm_source=summon&utm_medium=discovery-provider$$EView_record_in_SAGE_Publications$$FView_record_in_$$GSAGE_Publications</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26447199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gündüz, Sabahattin</creatorcontrib><creatorcontrib>Özkan, Mehmet</creatorcontrib><creatorcontrib>Yesin, Mahmut</creatorcontrib><creatorcontrib>Kalçık, Macit</creatorcontrib><creatorcontrib>Gürsoy, Mustafa Ozan</creatorcontrib><creatorcontrib>Karakoyun, Süleyman</creatorcontrib><creatorcontrib>Astarcıoğlu, Mehmet Ali</creatorcontrib><creatorcontrib>Aykan, Ahmet Çağrı</creatorcontrib><creatorcontrib>Gökdeniz, Tayyar</creatorcontrib><creatorcontrib>Biteker, Murat</creatorcontrib><creatorcontrib>Duran, Nilüfer Ekşi</creatorcontrib><creatorcontrib>Yıldız, Mustafa</creatorcontrib><title>Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis</title><title>Clinical and applied thrombosis/hemostasis</title><addtitle>Clin Appl Thromb Hemost</addtitle><description>Background:
The outcomes of thrombolytic therapy (TT) in elderly patients with prosthetic valve thrombosis (PVT) have not been evaluated previously. We investigated the outcomes of low-dose and slow infusion TT strategies in elderly patients with PVT.
Methods:
Twenty-seven (19 female) patients aged ≥65 years (median: 70 years, range: 65-82 years) were treated with repeated TT agents for PVT. The TT regimens included 24-hour infusion of 1.5 million units of streptokinase in 2 patients, 6-hour infusion of 25 mg recombinant tissue plasminogen activator (t-PA) in 12 patients, and 25-hour infusion of 25 mg t-PA in 13 patients. Treatment success and adverse event rates were assessed.
Results:
The initial and cumulative success rates were 40.7% and 85.2%, respectively. Adverse events occurred in 6 (22.2%) patients including 4 (14.8%) major (1 death, 1 rethrombosis, and 2 failed TT) and 2 (7.4%) minor (1 transient ischemic attack and 1 access site hematoma) events. Higher thrombus burden (thrombus area ≥1.1 cm2 by receiver operating characteristics analysis, sensitivity: 83.3%, specificity: 85%, area under the curve: 0.86, P = .008) and New York Heart Association class (0% vs 15.4% vs 25% vs 100% for classes I-IV, respectively, P = .02) predicted adverse events. By multiple variable analysis, thrombus area was the only independent predictor of adverse events (odds ratio: 13.8, 95% confidence interval: 1.02-185, P = .04).
Conclusion:
Slow infusion of low doses of TT agents (mostly t-PA) with repetition is successful and safe in elderly patients with PVT. However, excessive thrombus burden may predict adverse events.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood clots</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Evaluation</subject><subject>Female</subject><subject>Fibrinolytic Agents - administration & dosage</subject><subject>Fibrinolytic Agents - adverse effects</subject><subject>Heart Valve Prosthesis - adverse effects</subject><subject>Humans</subject><subject>Male</subject><subject>Predictive Value of Tests</subject><subject>Prostheses</subject><subject>Streptokinase - administration & dosage</subject><subject>Thrombolytic Therapy - adverse effects</subject><subject>Thrombolytic Therapy - methods</subject><subject>Thrombosis</subject><subject>Thrombosis - drug therapy</subject><subject>Thrombosis - etiology</subject><subject>Thrombosis - pathology</subject><subject>Tissue Plasminogen Activator - administration & dosage</subject><issn>1076-0296</issn><issn>1938-2723</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNp1kMFLwzAUxoMobk7vniTguZrXdGlylDndYOAOU48lbZO1o2tmkir7783YnCB4eg_e7_u-x4fQNZA7gDS9B5IyEgsGQ0YEE_wE9UFQHsVpTE_DHs7R7t5DF86tCIEAsXPUi1mSpCBEH1VzaxrTLlWJp63uXG1ah43GM_MVPRqn8KKyZp2bZuvrwuG6xeOmVLbZ4rn0tWq9w--1r3Cwcb5SAcITJa3Hb7L5PKpd7S7RmZaNU1eHOUCvT-PFaBLNXp6no4dZVCQk9ZEkuiBa8KQQidKpFAVnggInhEvKSU4LHfNcx6qUXAPkaa40iBwkZVwwIukA3e59N9Z8dMr5bGU624bILKZJAnyYAASK7Kki_O2s0tnG1mtptxmQbFdt9rfaILk5GHf5WpVHwU-XAYj2gJNL9Zv6r-E37H6Bkg</recordid><startdate>201704</startdate><enddate>201704</enddate><creator>Gündüz, Sabahattin</creator><creator>Özkan, Mehmet</creator><creator>Yesin, Mahmut</creator><creator>Kalçık, Macit</creator><creator>Gürsoy, Mustafa Ozan</creator><creator>Karakoyun, Süleyman</creator><creator>Astarcıoğlu, Mehmet Ali</creator><creator>Aykan, Ahmet Çağrı</creator><creator>Gökdeniz, Tayyar</creator><creator>Biteker, Murat</creator><creator>Duran, Nilüfer Ekşi</creator><creator>Yıldız, Mustafa</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>201704</creationdate><title>Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis</title><author>Gündüz, Sabahattin ; Özkan, Mehmet ; Yesin, Mahmut ; Kalçık, Macit ; Gürsoy, Mustafa Ozan ; Karakoyun, Süleyman ; Astarcıoğlu, Mehmet Ali ; Aykan, Ahmet Çağrı ; Gökdeniz, Tayyar ; Biteker, Murat ; Duran, Nilüfer Ekşi ; Yıldız, Mustafa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-a0fc0f984c94ef7a9c869318008a380b3cf28bf2eda8f11b7bef19b1a368960a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood clots</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Evaluation</topic><topic>Female</topic><topic>Fibrinolytic Agents - administration & dosage</topic><topic>Fibrinolytic Agents - adverse effects</topic><topic>Heart Valve Prosthesis - adverse effects</topic><topic>Humans</topic><topic>Male</topic><topic>Predictive Value of Tests</topic><topic>Prostheses</topic><topic>Streptokinase - administration & dosage</topic><topic>Thrombolytic Therapy - adverse effects</topic><topic>Thrombolytic Therapy - methods</topic><topic>Thrombosis</topic><topic>Thrombosis - drug therapy</topic><topic>Thrombosis - etiology</topic><topic>Thrombosis - pathology</topic><topic>Tissue Plasminogen Activator - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gündüz, Sabahattin</creatorcontrib><creatorcontrib>Özkan, Mehmet</creatorcontrib><creatorcontrib>Yesin, Mahmut</creatorcontrib><creatorcontrib>Kalçık, Macit</creatorcontrib><creatorcontrib>Gürsoy, Mustafa Ozan</creatorcontrib><creatorcontrib>Karakoyun, Süleyman</creatorcontrib><creatorcontrib>Astarcıoğlu, Mehmet Ali</creatorcontrib><creatorcontrib>Aykan, Ahmet Çağrı</creatorcontrib><creatorcontrib>Gökdeniz, Tayyar</creatorcontrib><creatorcontrib>Biteker, Murat</creatorcontrib><creatorcontrib>Duran, Nilüfer Ekşi</creatorcontrib><creatorcontrib>Yıldız, Mustafa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Clinical and applied thrombosis/hemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Gündüz, Sabahattin</au><au>Özkan, Mehmet</au><au>Yesin, Mahmut</au><au>Kalçık, Macit</au><au>Gürsoy, Mustafa Ozan</au><au>Karakoyun, Süleyman</au><au>Astarcıoğlu, Mehmet Ali</au><au>Aykan, Ahmet Çağrı</au><au>Gökdeniz, Tayyar</au><au>Biteker, Murat</au><au>Duran, Nilüfer Ekşi</au><au>Yıldız, Mustafa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis</atitle><jtitle>Clinical and applied thrombosis/hemostasis</jtitle><addtitle>Clin Appl Thromb Hemost</addtitle><date>2017-04</date><risdate>2017</risdate><volume>23</volume><issue>3</issue><spage>241</spage><epage>247</epage><pages>241-247</pages><issn>1076-0296</issn><eissn>1938-2723</eissn><abstract>Background:
The outcomes of thrombolytic therapy (TT) in elderly patients with prosthetic valve thrombosis (PVT) have not been evaluated previously. We investigated the outcomes of low-dose and slow infusion TT strategies in elderly patients with PVT.
Methods:
Twenty-seven (19 female) patients aged ≥65 years (median: 70 years, range: 65-82 years) were treated with repeated TT agents for PVT. The TT regimens included 24-hour infusion of 1.5 million units of streptokinase in 2 patients, 6-hour infusion of 25 mg recombinant tissue plasminogen activator (t-PA) in 12 patients, and 25-hour infusion of 25 mg t-PA in 13 patients. Treatment success and adverse event rates were assessed.
Results:
The initial and cumulative success rates were 40.7% and 85.2%, respectively. Adverse events occurred in 6 (22.2%) patients including 4 (14.8%) major (1 death, 1 rethrombosis, and 2 failed TT) and 2 (7.4%) minor (1 transient ischemic attack and 1 access site hematoma) events. Higher thrombus burden (thrombus area ≥1.1 cm2 by receiver operating characteristics analysis, sensitivity: 83.3%, specificity: 85%, area under the curve: 0.86, P = .008) and New York Heart Association class (0% vs 15.4% vs 25% vs 100% for classes I-IV, respectively, P = .02) predicted adverse events. By multiple variable analysis, thrombus area was the only independent predictor of adverse events (odds ratio: 13.8, 95% confidence interval: 1.02-185, P = .04).
Conclusion:
Slow infusion of low doses of TT agents (mostly t-PA) with repetition is successful and safe in elderly patients with PVT. However, excessive thrombus burden may predict adverse events.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>26447199</pmid><doi>10.1177/1076029615609698</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext_linktorsrc |
identifier | ISSN: 1076-0296 |
ispartof | Clinical and applied thrombosis/hemostasis, 2017-04, Vol.23 (3), p.241-247 |
issn | 1076-0296 1938-2723 |
language | eng |
recordid | cdi_proquest_journals_2344185411 |
source | Sage Journals GOLD Open Access 2024 |
subjects | Aged Aged, 80 and over Blood clots Dose-Response Relationship, Drug Drug Evaluation Female Fibrinolytic Agents - administration & dosage Fibrinolytic Agents - adverse effects Heart Valve Prosthesis - adverse effects Humans Male Predictive Value of Tests Prostheses Streptokinase - administration & dosage Thrombolytic Therapy - adverse effects Thrombolytic Therapy - methods Thrombosis Thrombosis - drug therapy Thrombosis - etiology Thrombosis - pathology Tissue Plasminogen Activator - administration & dosage |
title | Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T17%3A32%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_AFRWT&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prolonged%20Infusions%20of%20Low-Dose%20Thrombolytics%20in%20Elderly%20Patients%20With%20Prosthetic%20Heart%20Valve%20Thrombosis&rft.jtitle=Clinical%20and%20applied%20thrombosis/hemostasis&rft.au=G%C3%BCnd%C3%BCz,%20Sabahattin&rft.date=2017-04&rft.volume=23&rft.issue=3&rft.spage=241&rft.epage=247&rft.pages=241-247&rft.issn=1076-0296&rft.eissn=1938-2723&rft_id=info:doi/10.1177/1076029615609698&rft_dat=%3Cproquest_AFRWT%3E2344185411%3C/proquest_AFRWT%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c407t-a0fc0f984c94ef7a9c869318008a380b3cf28bf2eda8f11b7bef19b1a368960a3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2344185411&rft_id=info:pmid/26447199&rft_sage_id=10.1177_1076029615609698&rfr_iscdi=true |