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   thrombolysis with tissue plasminogen activator in patients with acute pulmonary embolisms in the real world: from the command vte registry  
   
نویسنده nishimoto yuji ,yamashita yugo ,morimoto takeshi ,saga syunsuke ,amano hidewo ,takase toru ,hiramori seiichi ,kim kitae ,oi maki ,akao masaharu ,kobayashi yohei ,toyofuku mamoru ,izumi toshiaki ,tada tomohisa ,chen po-min ,murata koichiro ,tsuyuki yoshiaki ,sasa tomoki ,sakamoto jiro ,kinoshita minako ,togi kiyonori ,mabuchi hiroshi ,takabayashi kensuke ,yoshikawa yusuke ,shiomi hiroki ,kato takao ,makiyama takeru ,ono koh ,sato yukihito ,kimura takeshi
منبع journal of thrombosis and thrombolysis - 2019 - دوره : 48 - شماره : 4 - صفحه:587 -595
چکیده    There is still uncertainty about the optimal usage of thrombolysis for acute pulmonary embolisms (pes), leading to a widely varying usage in the real world. the command vte registry is a multicenter retrospective registry enrolling consecutive patients with acute symptomatic venous thromboembolisms (vtes) in japan. the present study population consisted of 1549 patients with pes treated with tissue plasminogen activator (t-pa) thrombolysis (n = 180, 12%) or without thrombolysis (n = 1369). thrombolysis with t-pa was implemented in 33% of patients with severe pes, and 9.2% of patients with mild pes with a wide variation across the participating centers. patients with t-pa thrombolysis were younger, and less frequently had active cancer, history of major bleeding, and anemia. at 30 days, t-pa thrombolysis as compared to no thrombolysis was associated with similar mortality rates (5.0% vs. 6.9%, p = 0.33), but a lower adjusted mortality risk (or 0.41; 95% ci 0.18–0.90, p = 0.03), while it was associated with a trend for higher rates of major bleeding (5.6% vs. 2.9%, p = 0.06) and a significantly higher adjusted risk for major bleeding (or 2.39; 95% ci 1.06–5.36, p = 0.03). in patients with severe pes, the mortality rates at 30 days were significantly lower in the t-pa thrombolysis group than no thrombolysis group (15% vs. 37%, p = 0.006). in the present real-world vte registry in japan, t-pa thrombolysis was not infrequently implemented, not only in patients with severe pes, but also in patients with mild pes. a substantial mortality risk reduction might be suggested with t-pa thrombolysis in patients with severe pes.
کلیدواژه venous thromboembolism ,thrombolysis ,tissue plasminogen activator ,bleeding ,mortality
آدرس hyogo prefectural amagasaki general medical center, department of cardiology, japan, kyoto university, graduate school of medicine, department of cardiovascular medicine, japan, hyogo college of medicine, department of clinical epidemiology, japan, hyogo prefectural amagasaki general medical center, department of cardiology, japan, kurashiki central hospital, department of cardiovascular medicine, japan, kinki university hospital, department of cardiology, japan, kokura memorial hospital, department of cardiology, japan, kobe city medical center general hospital, department of cardiovascular medicine, japan, japanese red cross otsu hospital, department of cardiology, japan, national hospital organization kyoto medical center, department of cardiology, japan, osaka red cross hospital, department of cardiovascular center, japan, japanese red cross wakayama medical center, department of cardiology, japan, kitano hospital, cardiovascular center, the tazuke kofukai medical research institute, japan, shizuoka general hospital, department of cardiology, japan, osaka saiseikai noe hospital, department of cardiology, japan, shizuoka city shizuoka hospital, department of cardiology, japan, shimada municipal hospital, division of cardiology, japan, kishiwada city hospital, department of cardiology, japan, tenri hospital, department of cardiology, japan, nishikobe medical center, department of cardiology, japan, kinki university faculty of medicine, nara hospital, division of cardiology, japan, koto memorial hospital, department of cardiology, japan, hirakata kohsai hospital, department of cardiology, japan, kyoto university, graduate school of medicine, department of cardiovascular medicine, japan, kyoto university, graduate school of medicine, department of cardiovascular medicine, japan, kyoto university, graduate school of medicine, department of cardiovascular medicine, japan, kyoto university, graduate school of medicine, department of cardiovascular medicine, japan, kyoto university, graduate school of medicine, department of cardiovascular medicine, japan, hyogo prefectural amagasaki general medical center, department of cardiology, japan, kyoto university, graduate school of medicine, department of cardiovascular medicine, japan
 
     
   
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