PMID- 25630985
OWN - NLM
STAT- MEDLINE
DCOM- 20161221
LR  - 20161230
IS  - 1938-2723 (Electronic)
IS  - 1076-0296 (Linking)
VI  - 22
IP  - 4
DP  - 2016 May
TI  - Should Low-Molecular-Weight Heparin be Preferred Over Unfractionated Heparin 
      After Thrombolysis for Severity Pulmonary Embolism?
PG  - 395-9
LID - 10.1177/1076029614564863 [doi]
AB  - PURPOSE: The role of low-molecular-weight heparin (LMWH) in managing nonmassive 
      pulmonary embolism (PE) is well known. In unstable cases, especially after 
      thrombolytic therapy for massive PE, unfractionated heparin (UFH) is preferred 
      for PE management. This study aimed to investigate the effectiveness and safety 
      of LMWH after thrombolytic therapy. METHODS: A prospective, observational 
      multicenter trial was performed in 249 patients with acute PE who required 
      thrombolysis. Massive and submassive PEs were categorized into 2 groups depending 
      on whether they were treated with LMWH or UFH after thrombolytic treatment. The 
      primary end point was all-cause mortality during the first 30 days; the secondary 
      end point included all-cause mortality, nonfatal symptomatic recurrent PEs, or 
      nonfatal major bleeding. RESULTS: The mean age at diagnosis was 60.7 +/- 15.5 
      years. The PE severity was massive in 186 (74.7%) patients and submassive in 63 
      (25.3%). The incidence of all-cause 30-day death was 8.2% and 17.3% in patients 
      with LMWH and UFH, respectively (P = .031). Major hemorrhage occurred in 4% (n = 
      5) and 7.9% (n = 10) of patients and minor hemorrhage occurred in 9% (n = 11) and 
      13.4% (n = 17) of the cases treated with LMWH and UFH, respectively. CONCLUSION: 
      These results suggest that LMWH treatment can be used safely in patients with PE 
      after thrombolytic therapy.
CI  - (c) The Author(s) 2015.
FAU - Senturk, Aysegul
AU  - Senturk A
AD  - Department of Pulmonary Medicine, Ankara Ataturk Training and Research Hospital, 
      Ankara, Turkey asenturk1967@yahoo.com.
FAU - Ucar, Elif Yilmazel
AU  - Ucar EY
AD  - Department of Pulmonary Medicine, Ataturk University School of Medicine, Erzurum, 
      Turkey.
FAU - Berk, Serdar
AU  - Berk S
AD  - Department of Pulmonary Medicine, Cumhuriyet University, School of Medicine, 
      Sivas, Turkey.
FAU - Ozlu, Tevfik
AU  - Ozlu T
AD  - Department of Pulmonary Medicine, Karadeniz Technical University, School of 
      Medicine, Trabzon, Turkey.
FAU - Altinsoy, Bulent
AU  - Altinsoy B
AD  - Department of Pulmonary Medicine, Bulent Ecevit University School of Medicine, 
      Zonguldak, Turkey.
FAU - Dabak, Gul
AU  - Dabak G
AD  - Department of Pulmonary Medicine, Istanbul Kartal Kosuyolu Yuksek Ihtisas 
      Training and Research Hospital, Istanbul, Turkey.
FAU - Cakir, Ebru
AU  - Cakir E
AD  - Department of Pulmonary Medicine, Trakya University, School of Medicine, Edirne, 
      Turkey.
FAU - Kadioglu, Esra Ekbic
AU  - Kadioglu EE
AD  - Department of Pulmonary Medicine, Erzurum Regional Training and Research 
      Hospital, Erzurum, Turkey.
FAU - Sen, Hadice Selimoglu
AU  - Sen HS
AD  - Department of Pulmonary Medicine, Dicle University School of Medicine, 
      Diyarbakir, Turkey.
FAU - Ozsu, Savas
AU  - Ozsu S
AD  - Department of Pulmonary Medicine, Karadeniz Technical University, School of 
      Medicine, Trabzon, Turkey.
CN  - TUPEG Study Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20150127
PL  - United States
TA  - Clin Appl Thromb Hemost
JT  - Clinical and applied thrombosis/hemostasis : official journal of the 
      International Academy of Clinical and Applied Thrombosis/Hemostasis
JID - 9508125
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Middle Aged
MH  - Pulmonary Embolism/*drug therapy
MH  - Severity of Illness Index
MH  - *Thrombolytic Therapy
OTO - NOTNLM
OT  - low-molecular-weight heparin
OT  - pulmonary thromboembolism
OT  - unfractionated heparin
EDAT- 2015/01/30 06:00
MHDA- 2016/12/22 06:00
CRDT- 2015/01/30 06:00
PHST- 2015/01/30 06:00 [entrez]
PHST- 2015/01/30 06:00 [pubmed]
PHST- 2016/12/22 06:00 [medline]
AID - 1076029614564863 [pii]
AID - 10.1177/1076029614564863 [doi]
PST - ppublish
SO  - Clin Appl Thromb Hemost. 2016 May;22(4):395-9. doi: 10.1177/1076029614564863. 
      Epub 2015 Jan 27.