Document Detail

Tissue plasminogen activator for the treatment of acute pulmonary embolism. A collaborative study by the PIOPED Investigators.
MedLine Citation:
PMID:  2106408     Owner:  NLM     Status:  MEDLINE    
Thirteen patients with acute pulmonary embolism were treated in a randomized double-blind fashion either with recombinant tissue plasminogen activator (rt-PA) 40 to 80 mg, usually in combination with heparin, or with placebo plus heparin. The drug was administered intravenously over 40 to 90 minutes. Nine patients received rt-PA, and four received placebo. A lytic effect was observed 1.5 and three hours after the onset of therapy with rt-PA based upon elevated levels of fragment-D dimers. Among the patients who received rt-PA, there was a modest improvement of the total pulmonary resistance 1.5 hours after the start of therapy, but the angiograms showed no significant changes in two hours. After 24 hours, the lung scans showed a trend toward greater improvement with rt-PA, but the rate of improvement in comparison to control subjects was not statistically significant. Massive bleeding occurred in one patient. The observations in this study suggest that rt-PA has little effect in two hours on angiographic clot burden, but may produce some improvement in hemodynamics. The treatment, however, is not without risk.
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  97     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1990 Mar 
Date Detail:
Created Date:  1990-04-02     Completed Date:  1990-04-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  528-33     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Disease
Aged, 80 and over
Double-Blind Method
Heparin / administration & dosage,  therapeutic use
Infusions, Intravenous
Middle Aged
Multicenter Studies as Topic
Pulmonary Embolism / drug therapy*,  physiopathology,  radiography
Random Allocation
Recombinant Proteins / administration & dosage,  therapeutic use
Tissue Plasminogen Activator / administration & dosage,  therapeutic use*
Vascular Resistance
Ventilation-Perfusion Ratio
Reg. No./Substance:
0/Placebos; 0/Recombinant Proteins; 9005-49-6/Heparin; EC Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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