| Safety of withholding anticoagulant therapy in patients with suspected pulmonary embolism with a negative multislice computed tomography pulmonary angiography. | |
| | |
MedLine Citation:
|
PMID: 20603036 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: To assess the safety of withholding anticoagulant therapy in patients with clinically suspected pulmonary embolism with a negative multislice computed tomography pulmonary angiography (MCTPA). METHODS: Three hundred and eighty six patients who were consecutively assessed in the emergency room of our institution for suspected pulmonary embolism were eligible for our study. Patients with either a low or an intermediate clinical probability of pulmonary embolism according to the Wells score and a negative MCTPA for pulmonary embolism were enrolled. Patients with anticoagulant therapy for other medical conditions were excluded from this study. We assessed the percentage of patients in whom venous thromboembolic events or death related to this condition within three months after the negative CT. RESULTS: Two hundred and forty two patients were included in our series [mean age+/-standard deviation (SD) (63.1+/-18.1)]. Only one patient (0.41% [95% confidence interval -0.4%-1.22%]) showed a non-fatal pulmonary embolism during the three-month follow-up period after an initial negative CT scan (negative predictive value, 99.58%). Eleven patients died during the follow-up period due to conditions unrelated to venous thromboembolic disease (pneumonia [n=5], lung cancer [n=2], wasting syndrome [n=1], acute myocardial infarction [n=1], leiomyosarcoma [n=1], and severe pulmonary hypertension [n=1]). CONCLUSIONS: Withholding anticoagulant therapy in patients with suspected venous thromboembolic disease with a negative result on MCTPA seems to be safe in our clinical setting. |
| | |
Authors:
|
Javier Galipienzo; Jaime García de Tena; Julio Flores; Concepción Alvarez; Soledad Alonso-Viteri; Antonio Ruiz |
Related Documents
:
|
18160596 - Pulmonary embolism in medical patients: an autopsy-based study. 7148876 - Factors associated with correct antemortem diagnosis of major pulmonary embolism. 1000926 - The diagnosis of pulmonary embolism. 15323216 - Multi-slice computed tomography in the diagnosis of pulmonary embolism--usefulness of m... 15553936 - Endothelin and effects of endothelin-receptor activation in the mammary and radial artery. 2524266 - Clinical experience with the use of the angled-balloon dilatation catheter. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-03 |
Journal Detail:
|
Title: European journal of internal medicine Volume: 21 ISSN: 1879-0828 ISO Abbreviation: Eur. J. Intern. Med. Publication Date: 2010 Aug |
Date Detail:
|
Created Date: 2010-07-06 Completed Date: 2010-11-09 Revised Date: 2011-02-04 |
Medline Journal Info:
|
Nlm Unique ID: 9003220 Medline TA: Eur J Intern Med Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 283-8 Citation Subset: IM |
Affiliation:
|
Servicio de Urgencias, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain. javiergalipienzogarcia@yahoo.es |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anticoagulants / therapeutic use* Diagnosis, Differential Female Humans Lung / blood supply, radiography Male Middle Aged Prospective Studies Pulmonary Circulation Pulmonary Embolism / complications, diagnosis*, drug therapy, mortality, radiography Tomography, X-Ray Computed* Venous Thromboembolism / etiology |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants |
| Comments/Corrections | |
Comment In:
|
Eur J Intern Med. 2011 Feb;22(1):122; author reply 122-3
[PMID:
21238911
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Delay and misdiagnosis in sub-massive and non-massive acute pulmonary embolism.
Next Document: Single nucleotide polymorphisms in inflammation-related genes are associated with venous thromboembo...