Open AccessComparison of long‐term outcomes of 50 and 100 mg rt‐PA in the management of acute pulmonary thromboembolism
Author(s) -
Yilmazel Ucar Elif,
Araz Omer,
Kerget Bugra,
Yilmaz Nafiye,
Akgun Metin,
Saglam Leyla
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12721
Subject(s) - medicine , mortality rate , pulmonary embolism , malignancy , gastroenterology , retrospective cohort study , pulmonary hypertension
Background Pulmonary thromboembolism (PTE) is a life‐threatening disease. In this study, we aimed to evaluate long‐term outcomes of the use of 50 mg recombinant tissue‐type plasminogen activator (rt‐PA) in the management of PTE in terms of relapse, pulmonary hypertension (PH), mortality and hemorrhage and to compare with the use of 100 mg rt‐PA. Methods The study was designed as a retrospective cohort. Patients who were diagnosed as acute PTE and received either 50 or 100 mg rt‐PA in a tertiary care hospital between 2010 and 2015 were included in the study. Rates of relapse, PH, mortality (in‐hospital and long‐term) and hemorrhage (major and minor) were calculated for each treatment group. Results A total 117 patients, 73 females and 44 males, were evaluated. Eighty‐three patients were administered 100 mg rt‐PA, and 34 were administered 50 mg rt‐PA. The mean age was lower in the 100 mg group compared to the 50 mg group (61 ± 15 vs 69 ± 14 years). There was a significant decrease in PH in each group at 3 months follow‐up ( P < .001). Although statistically nonsignificant, the relapse rate was lower in the 50 mg rt‐PA group, but the 5‐year mortality rate was higher in 50 mg rt‐PA group (35.2% vs 27.7%, P = .50). Mortality was associated with older age and presence of malignancy. Conclusions Our results suggest that both doses of rt‐PA have similar efficacy. The high mortality rate in the 50 mg group may have resulted from patient selection.