Moderate Pulmonary Embolism Treated With Thrombolysis (from the “MOPETT” Trial)

• Published in: The American journal of cardiology 2013-01, Vol.111 (2), p.273-277
• Main Authors: Sharifi, Mohsen, MD, Bay, Curt, PhD, Skrocki, Laura, DO, Rahimi, Farnoosh, MD, Mehdipour, Mahshid, DMD
• Format: Article
• Language: English
• Subjects: Arizona - epidemiology; Cardiovascular; Catheters; Drug therapy; Female; Fibrinolytic Agents - therapeutic use; Follow-Up Studies; Heart attacks; Humans; Length of Stay - trends; Male; Middle Aged; Prospective Studies; Pulmonary arteries; Pulmonary Embolism - drug therapy; Pulmonary Embolism - mortality; Survival Rate - trends; Thrombolytic Therapy - methods; Treatment Outcome; Veins & arteries
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2012.09.027

The role of low-dose thrombolysis in the reduction of pulmonary artery pressure in moderate pulmonary embolism (PE) has not been investigated. Because the lungs are very sensitive to thrombolysis, we postulated that effective and safe thrombolysis might be achieved by a lower dose of tissue plasminogen activator. The purpose of the present study was to evaluate the role of this “safe dose” thrombolysis in the reduction of pulmonary artery pressure in moderate PE. During a 22-month period, 121 patients with moderate PE were randomized to receive a “safe dose” of tissue plasminogen activator plus anticoagulation (thrombolysis group [TG], n = 61 patients) or anticoagulation alone (control group [CG], n = 60). The primary end points consisted of pulmonary hypertension and the composite end point of pulmonary hypertension and recurrent PE at 28 months. Pulmonary hypertension and the composite end point developed in 9 of 58 patients (16%) in the TG and 32 of 56 patients (57%) in the CG (p