Association between reperfusion therapy and outcomes in patients with acute pulmonary embolism and right heart thrombi. Issue 5 (5th November 2020)

• Record Type: Journal Article
• Authors: Bikdeli, Behnood; Jiménez, David; Muriel, Alfonso; Barrios, Deisy; Ballaz, Aitor; Verhamme, Peter; Monreal, Manuel
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Blanco-Molina A author non-byline.; Camon AM author non-byline.; Castro J author non-byline.; Criado J author non-byline.; Culla A author non-byline.; de Miguel J author non-byline.; del Toro J author non-byline.; Demelo-Rodríguez P author non-byline.; Díaz-Pedroche MC author non-byline.; Díaz-Peromingo JA author non-byline.; Díez-Sierra J author non-byline.; Domínguez IM author non-byline.; Escribano JC author non-byline.; Fernández-Capitán C author non-byline.; Fernández-Reyes JL author non-byline.; Fidalgo MA author non-byline.; Flores K author non-byline.; Font C author non-byline.; Font L author non-byline.; Francisco I author non-byline.; Furest I author non-byline.; Gabara C author non-byline.; García MA author non-byline.; García-Bragado F author non-byline.; García-Raso A author non-byline.; Gavín-Blanco O author non-byline.; Gavín-Sebastián O author non-byline.; Gayol MC author non-byline.; Gil-Díaz A author non-byline.; Gómez-Cuervo C author non-byline.; González-Martínez J author non-byline.; 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Bertoletti L author non-byline.; Bura-Riviere A author non-byline.; Debourdeau P author non-byline.; Courtois MC author non-byline.; Farge-Bancel D author non-byline.; Helfer H author non-byline.; Hij A author non-byline.; Mahé I author non-byline.; Moustafa F author non-byline.; Schellong S author non-byline.; Braester A author non-byline.; Brenner B author non-byline.; Tzoran I author non-byline.; Amitrano M author non-byline.; Bilora F author non-byline.; Bortoluzzi C author non-byline.; Brandolin B author non-byline.; Bucherini E author non-byline.; Ciammaichella M author non-byline.; Dentali F author non-byline.; Di Micco P author non-byline.; Grandone E author non-byline.; Imbalzano E author non-byline.; Maida R author non-byline.; Pace F author non-byline.; Pesavento R author non-byline.; Prandoni P author non-byline.; Quintavalla R author non-byline.; Rocci A author non-byline.; Siniscalchi C author non-byline.; Tiraferri E author non-byline.; Tufano A author non-byline.; Visonà A author non-byline.; Vo Hong N author non-byline.; Zalunardo B author non-byline.; Kigitovica D author non-byline.; Skride A author non-byline.; Strautmane S author non-byline.; Ferreira M author non-byline.; Bosevski M author non-byline.; Zdraveska M author non-byline.; Bounameaux H author non-byline.; Mazzolai L author non-byline.; Bikdeli B author non-byline.; Caprini JA author non-byline.; Tafur AJ author non-byline.; Weinberg I author non-byline.; Wilkins H author non-byline.; Bui HM author non-byline.;
• Is Part Of: European respiratory journal. Volume 56:Issue 5(2020)
• Publication Date: 2020-11-05
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.00538-2020
• Languages: English
• ISSNs: 0903-1936

Abstract

Right heart thrombi (RHT) may be detected in <4% of patients with pulmonary embolism (PE) [1 ], and are associated with worse outcomes [1–4]. Given the limited existing evidence, society guidelines or consensus statements have either not addressed the management of RHT, or have based their recommendations on prior case reports, case series or pooled results of case series [5–8]. It is plausible that reperfusion strategies reduce the adverse outcomes in PE patients with RHT; thrombolysis may dissolve the RHT and emboli, while thrombectomy might reduce the thromboembolic burden. Using the data from RIETE (Registro Informatizado Enfermedad TromboEmbolica), a prospective international venous thromboembolism registry, we sought to compare the outcomes of patients with PE and coexisting RHT, with versus without reperfusion therapy. Right heart thrombi portend worse outcomes in pulmonary embolism (PE). In propensity-matched analyses of patients from a large registry, reperfusion therapy was not associated with significantly reduced odds of all-cause or PE-related mortality. https://bit.ly/2WRLYnq