| Streptokinase and Heparin versus Heparin Alone in Massive Pulmonary Embolism: A Randomized Controlled Trial. | |
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MedLine Citation:
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PMID: 10608028 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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To test the efficacy of thrombolytic therapy in massive pulmonary embolism, we conducted a prospective randomized controlled trial. Eight patients were randomized to receive either 1,500,000 IU of streptokinase in 1 hour through a peripheral vein followed by heparin or heparin alone. All patients had major risk factors for deep vein thrombosis (DVT) and were considered to have high clinical suspicion for pulmonary embolism (PE). At baseline all patients had a similar degree of systemic arterial hypotension, pulmonary arterial hypertension, and right ventricular dysfunction. The time of onset of cardiogenic shock in both groups was comparable (2.25 +/- 0.5 hours in the streptokinase group and 1.75 +/- 0.96 hours in the heparin group). The four patients who were randomized to streptokinase improved in the first hour after treatment, survived, and in 2 years of follow-up are without pulmonary arterial hypertension. All four patients treated with heparin alone died from 1 to 3 hours after arrival at the emergency room (p = 0.02). Post-thrombolytic therapy the diagnosis of PE was sustained in the streptokinase group by high probability V/Q lung scans and proven DVT. A necropsy study performed in three patients in the heparin group showed massive pulmonary embolism and right ventricular myocardial infarction, without significant coronary arterial obstruction. The results indicate that thrombolytic therapy reduces the mortality rate of massive acute pulmonary embolism. |
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Authors:
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Jerjes-Sanchez; Ramírez-Rivera; de Lourdes García M; Arriaga-Nava; Valencia; Rosado-Buzzo; Pierzo; Rosas |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Journal of thrombosis and thrombolysis Volume: 2 ISSN: 1573-742X ISO Abbreviation: J. Thromb. Thrombolysis Publication Date: 1995 |
Date Detail:
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Created Date: 1999-12-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9502018 Medline TA: J Thromb Thrombolysis Country: - |
Other Details:
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Languages: ENG Pagination: 227-229 Citation Subset: - |
Affiliation:
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Amores 1636 Edificio "D," Depto 503, CP 03100, Mexico City, Mexico and Emergency Care Department, Hospital de Cardiologia, National Medical Center, Mexico City, Mexico. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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