Low-Dose Alteplase versus Conventional Anticoagulation to treat Submassive Pulmonary Embolism in Hispanic Patients

Emily Zientek; Kelsey Talkington; Joshua Gardner; Yi Guo; Debabrata Mukherjee; Manu Rajachandran; Tariq S. Siddiqui; Nils P. Nickel

doi:10.1055/s-0042-1758386

International Journal of Angiology, Inhaltsverzeichnis

Int J Angiol 2023; 32(02): 131-135
DOI: 10.1055/s-0042-1758386

Rapid Communication

Low-Dose Alteplase versus Conventional Anticoagulation to treat Submassive Pulmonary Embolism in Hispanic Patients

Emily Zientek

¹Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

,

Kelsey Talkington

¹Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

,

Joshua Gardner

¹Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

,

Yi Guo

²Department of Pharmacy, Clinical Pharmacy Services, University Medical Center of El Paso, El Paso, Texas

,

Debabrata Mukherjee

¹Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

³Department of Internal Medicine, Division of Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

,

Manu Rajachandran

¹Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

³Department of Internal Medicine, Division of Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

,

Tariq S. Siddiqui

¹Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

³Department of Internal Medicine, Division of Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

,

Nils P. Nickel

¹Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

⁴Department of Internal Medicine, Division of Pulmonary and Critical Care, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

› Institutsangaben

Abstract

The use of low-dose tissue plasminogen activator (tPA) in Hispanic patients with submassive pulmonary embolism (PE) is understudied.

The purpose of this study is to explore the use of low-dose tPA in Hispanic patients with submissive PE compared with counterparts that received heparin alone.

We retrospectively analyzed a single-center registry of patients with acute PE between 2016 and 2022. Out of 72 patients admitted for acute PE and cor pulmonale, we identified six patients that were treated with conventional anticoagulation (heparin alone) and six patients who received low-dose tPA (and heparin afterward). We analyzed if low-dose tPA was associated with differences in length of stay (LOS) and bleeding complications.

Both groups were similar in regard to age, gender, and PE severity (based on Pulmonary Embolism Severity Index scores). Mean total LOS for the low-dose tPA group was 5.3 days, compared with 7.3 days in the heparin group (p = 0.29). Mean intensive care unit (ICU) LOS for the low-dose tPA group was 1.3 days compared with 3 days in the heparin group (p = 0.035). There were no clinically relevant bleeding complications documented in either the heparin or the low-dose tPA group.

Low-dose tPA for submassive PE in Hispanic patients was associated with a shorter ICU LOS without a significant increase in bleeding risk. Low-dose tPA appears to be a reasonable treatment option in Hispanic patients with submassive PE who are not at high bleeding risk (<5%).

Keywords

pulmonary embolism - length of stay - Hispanic - hemodynamics - low-dose alteplase - tissue plasminogen activator - anticoagulation

Volltext

Referenzen

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