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Impact of Reperfusion on Clinical Outcomes in Patients with Intermediate-High Risk Pulmonary Embolism.
Bobadilla, Leandro; Scatularo, Cristhian Emmanuel; Antoniolli, Melisa; Lerech, Ezequiel; Cigalini, Ignacio Manuel; Zaidel, Ezequiel Jose.
Afiliación
  • Bobadilla L; Division of Cardiology, Sanatorio Güemes, Buenos Aires city, Argentina.
  • Scatularo CE; Division of Cardiology, Sanatorio de la Trinidad de Palermo, Buenos Aires city, Argentina. Electronic address: conarecoficial@gmail.com.
  • Antoniolli M; Division of Cardiology, Sanatorio Finochietto, Buenos Aires city, Argentina.
  • Lerech E; Division of Cardiology, Durand Hospital, Buenos Aires city, Argentina.
  • Cigalini IM; Division of interventional cardiology, Grupo Gamma, Rosario, Argentina.
  • Zaidel EJ; Division of Cardiology, Sanatorio Güemes, Buenos Aires city, Argentina.
Curr Probl Cardiol ; 47(10): 101308, 2022 Oct.
Article en En | MEDLINE | ID: mdl-35793712
The prognosis of pulmonary embolism (PE) depends on its correct stratification, and reperfusion in intermediate-risk pulmonary embolism is controversial yet. Our aim is to explore variables associated with the decision of reperfusion in patients with intermediate-high risk PE and its impact on clinical outcomes. An analysis of a multicenter PE registry was performed. Patients with intermediate-high risk (classification of the European Society of Cardiology) were selected, and factors associated with the reperfusion decision and its impact on clinical outcomes were explored. From 684 consecutive patients of acute PE, 178 (26%) were intermediate-high risk cases and constituted the study population. Sixteen percent (n = 28) of this cohort received reperfusion treatment, either systemic thrombolysis (89%) or endovascular treatments. Differences were observed between the patients who received reperfusion or not, mainly in terms of age (57±17 years vs 68±14; P <0.001) and location of thrombi in both pulmonary arteries (78% vs 43.7%, respectively; OR 4.72; 95% CI 1.8-12.3; P <0.001). No significant differences were observed in total bleeding and major bleeding. Total mortality was 3.6% in the reperfusion group and 14% in the non-reperfusion group (OR 0.22, 95% CI 0.02-1.76; P = 0.1). Among patients with intermediate-high risk PE from Argentina, the decision of reperfusion has been influenced by age and the location of thrombi. The difference of 10 absolute points in mortality, with a similar rate of bleeding, favors the indication of reperfusion.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Trombosis Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Curr Probl Cardiol Año: 2022 Tipo del documento: Article País de afiliación: Argentina Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Trombosis Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Curr Probl Cardiol Año: 2022 Tipo del documento: Article País de afiliación: Argentina Pais de publicación: Países Bajos