Thursday, March 21, 2013

Lytics for submassive PE: Is the controversy any closer to being resolved?

No, despite two recently completed trials, one recently published and one just presented in abstract form at ACC.  The former study, published in the American Journal of Cardiology, using half dose TPA, showed good safety (no major bleeding) but improvement in only soft endpoints attributable to TPA.  The study presented at ACC showed improvement mainly in soft endpoints and a concerning increase in major bleeding attributable to thrombolysis.  So read the studies and opine as you will but my bottom line remains that thrombolysis for submassive PE is not well supported.

There is a nice summary on this topic over at Academic Life in Emergency Medicine.

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