Interv Akut Kardiol. 2006;5(4):157-162

TREATMENT OF ACUTE PULMONARY EMBOLISM IN LOCAL HOSPITAL

Margita Belicová, Marian Mokáň

I. Interná klinika MFN Martin

We are introducing retrospective analysis of treatment of 229 patients with acute pulmonary embolism (PE), representing 0.83 % of all 27 747 patients who were hospitalized in our clinic between 1996 and 2005.

Aim: We concentrated on thrombolytic treatment (TT) especially in patients with acute non massive PE and right ventricular dysfunction (RVD).

Study group and methods: Out of 229 patients (119 women) 42 patients had massive PE, 184 patients had non massive PE and 103 of them RVD on baseline echocardiography and 3 patients had chronic thromboembolic pulmonary hypertension. 73 patients were treated with thrombolysis (32 patients with massive PE and 41 patients with non massive PE and RVD) and 156 patients were treated with heparin alone. Based on hospital mortality rate in patients with non massive PE and RVD we evaluated TT compared to heparin alone. We evaluated also the role of assessment troponin T before initiation of treatment.

Results: Hospital mortality rate of patients with massive PE, who were treated with thrombolysis was 56 %. While we compared hospital mortality rate of patient with non massive PE and RVD, who were treated with thrombolysis or with heparin alone, patients, who were treated with thrombolysis had lower hospital mortality rate than patients, who were treated with heparin alone (2,4 % vs. 13 %, p = 0,06). If we decided to treat with heparin according to clinical severity without examination of troponin T compare to patients when we decide for this treatment because of negative troponin T and compared hospital mortality rate in both groups, we did not find out any significant difference (11 % vs. 20 %, p = 0,34).

Conclusions: TT is the way to save life of patients with massive PE. Efect of treatment with heparin alone in patients with non massive PE and RVD and negative troponin T is insufficient. Patients with non massive PE and RVD and negative troponin T require also often TT.

Keywords: Key words: pulmonary embolism, right ventricular dysfunction, thrombolysis, heparin.

Published: February 1, 2007  Show citation