Téma: 

Trombolitic therapy of acute pulmonary embolism and haemodynamically stabile patients

Margita Belicová, Róbert Olos, Marián Mokáň

We present the analysis of treatment of 229 patients with acute pulmonary embolism, i.e. 0.83 % out of 27 747 of patients hospitalized at our clinic in the period of years 1996 - 2005. Aim of the study: We focused on patients haemodynamically stabile with acute dysfunction of the right ventricle and compared thrombolitic treatment with anticoagulation treatment with heparin according to hospital mortality. Patients and Methods: Out of 229 patients (119 women) with pulmonary embolism 73 were given thrombolitic treatment and 156 patients were treated by heparin. Out of 229 patients 184 were haemodynamically stabile and 103 patients showed in echocardiographic examination acute dysfunction of the right ventricle. According to hospital mortality thrombolitic treatment was evaluated in comparison with heparin treatment in the group of patients who were haemodynamically stabile and had acute dysfunction of the right ventricle. Then heparin treatment was evaluated if the treatment was indicated for negative troponin T compared with heparin treatment when the treatment was indicated according to clinical picture and troponin was not examined. Results: Patients treated with thrombolitic treatment had lower hospital mortality compared with patients treated with heparin (2,4 % vs. 13 %, p = 0.06). None significant difference in hospital mortality (11 % vs. 20 %, p = 0.34) was found in heparin treatment indicated by clinical picture without evaluation of troponin T examination compared with heparin treatment in negative troponin T. Conclusion: Prefering of heparin treatment to thrombolitic treatment in patients with pulmonary embolism with acute dysfunction of the right ventricle and who are haemodynamically stabile and at the same time who have negative troponin T is insufficient. Thrombolitic treatment is often needed even in patients with negative troponin T.

Ročník 2006  Témy časopisu Internal medicine 9 / 2006

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