PMID- 25351610
OWN - NLM
STAT- MEDLINE
DCOM- 20151028
LR  - 20211021
IS  - 1432-1750 (Electronic)
IS  - 0341-2040 (Linking)
VI  - 193
IP  - 1
DP  - 2015 Feb
TI  - Comparison of LMWH versus UFH for hemorrhage and hospital mortality in the 
      treatment of acute massive pulmonary thromboembolism after thrombolytic treatment 
      : randomized controlled parallel group study.
PG  - 121-7
LID - 10.1007/s00408-014-9660-z [doi]
AB  - PURPOSE: Current guidelines recommend the use of low molecular weight heparin 
      (LMWH) for most haemodynamically stable patients with pulmonary thromboembolism 
      (PTE), however, it is not clear whether LMWH is preferable to unfractionated 
      heparin (UFH) for the treatment of massive PTE. We aimed to compare the use of 
      LMWH versus UFH after thrombolytic treatment in the management of acute massive 
      PTE for hemorrhage and hospital mortality. METHODS: The study, a randomized, 
      single center, parallel design trial, included the patients who had confirmed the 
      diagnosis of massive PTE according to clinical findings and computerized thorax 
      angiography and no contraindication to the treatment between January 2011 and 
      October 2013. After thrombolytic treatment, the patients assigned to therapy with 
      LMWH or UFH. Any hemorrhage, major hemorrhage, and hospital mortality were 
      assessed. RESULTS: A total of 121 patients, 71 female (58.7 %) and 50 male (41.3 
      %), who had massive PTE with an average age 62.6 +/- 15.7 (ranges 22-87) were 
      included for analyses in the study. They were allocated to either LMWH (n = 60) 
      or UFH (n = 61) group. Although the occurrence of any adverse event (21.7 vs 27.9 
      %) and each individual type of adverse event were all lower in the LMWH group 
      compared to UFH group (6.7 vs 11.5 %, 3.3 vs 9.8 %, and 15.0 vs 19.7 % for death, 
      major hemorrhage, and any hemorrhage, respectively), the differences were not 
      statistically significant. CONCLUSIONS: Our findings suggest that LMWH might be a 
      better option in the management of the patients with massive PTE. Multi-center 
      larger randomized controlled trials are required to confirm our results.
FAU - Ucar, Elif Yilmazel
AU  - Ucar EY
AD  - Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, 
      Erzurum, Turkey, eucar1979@yahoo.com.
FAU - Akgun, Metin
AU  - Akgun M
FAU - Araz, Omer
AU  - Araz O
FAU - Tas, Hakan
AU  - Tas H
FAU - Kerget, Bugra
AU  - Kerget B
FAU - Meral, Mehmet
AU  - Meral M
FAU - Kaynar, Hasan
AU  - Kaynar H
FAU - Saglam, Leyla
AU  - Saglam L
LA  - eng
SI  - ClinicalTrials.gov/NCT01956955
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20141029
PL  - United States
TA  - Lung
JT  - Lung
JID - 7701875
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Female
MH  - Hemorrhage/chemically induced/mortality/*prevention & control
MH  - Heparin/adverse effects/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/adverse effects/*therapeutic use
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Embolism/blood/diagnosis/*drug therapy/mortality
MH  - Risk Assessment
MH  - Risk Factors
MH  - *Thrombolytic Therapy/adverse effects/mortality
MH  - Time Factors
MH  - Treatment Outcome
MH  - Turkey
MH  - Young Adult
EDAT- 2014/10/30 06:00
MHDA- 2015/10/29 06:00
CRDT- 2014/10/30 06:00
PHST- 2014/06/27 00:00 [received]
PHST- 2014/10/11 00:00 [accepted]
PHST- 2014/10/30 06:00 [entrez]
PHST- 2014/10/30 06:00 [pubmed]
PHST- 2015/10/29 06:00 [medline]
AID - 10.1007/s00408-014-9660-z [doi]
PST - ppublish
SO  - Lung. 2015 Feb;193(1):121-7. doi: 10.1007/s00408-014-9660-z. Epub 2014 Oct 29.