Improving adjunctive treatment in pulmonary embolism and fibrinolytic therapy. The role of enoxaparin and weight-adjusted unfractionated heparin.

Journal of Thrombosis and Thrombolysis
Carlos Jerjes-SánchezAlfredo Comparan-Nuñez

Abstract

The role of enoxaparin and weight-adjusted unfractionated heparin (UH) as adjunct to fibrinolytic therapy in pulmonary embolism is unknown. In a prospective, open-label, controlled multicenter trial, 80 patients with high-risk pulmonary embolism were enrolled. Forty patients received alteplase infusion plus weight-adjusted UH (24-48 h) and then enoxaparin (7 days). In control group, UH standard regimen was used. There were not differences on pulmonary embolism extension, (P 0.63) and right ventricular hypokinesis (P 0.07) in both groups. In terms of in-hospital survival (P 0.009), escalation treatment (P < 0.001) and in-hospital stay (P < 0.001) study group had better outcome than opposite group. In a 30 (P < 0.001) and 90 (P < 0.001) days follow-up pulmonary perfusion was improved in patients who received enoxaparin versus heparin alone without increasing major bleeding complications. Enoxaparin and weight-adjusted intravenous UH as adjunct to 1-h alteplase infusion improve in-hospital and follow-up outcome compared to heparin alone in high-risk PE.

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Citations

Aug 12, 2014·The Clinical Respiratory Journal·Omer ArazMetin Akgun
May 29, 2013·International Journal of Cardiology·Anna Budaj-FideckaUNKNOWN ZATPOL Registry Investigators
Apr 23, 2011·Journal of Cardiovascular Pharmacology and Therapeutics·Linda M HiebertSandra M Wice
Oct 19, 2017·The Clinical Respiratory Journal·Elif Yilmazel UcarLeyla Saglam
Jul 22, 2017·Journal of Thrombosis and Thrombolysis·Eduardo Vazquez-GarzaDavid Rodriguez
Mar 11, 2017·Archivos de cardiología de México·Carlos Jerjes-SanchezAlicia Ramirez-Rivera
Apr 30, 2020·Journal of Thrombosis and Thrombolysis·David RodriguezFrancisco Nevarez
Mar 6, 2021·Journal of Thrombosis and Thrombolysis·Mauricio Castillo-PerezMauricio Vazquez-Guajardo

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