Pulmonary Embolism Clinical Trial
Official title:
Low Dose Prolonged Infusion of Tissue Type Plasminogen Activator Therapy in Massive Pulmonary Embolism: AYKAN Trial
The aim of the present study was to assess the effects of low-dose (25mg) prolonged administration (in 6 hours) of tissue type plasminogen activator (tPA) on in-hospital mortality and outcomes in patients with massive PE.
Pulmonary embolism (PE) is life threatening disease requiring early diagnosis and treatment.
Thrombolytic therapy (TT) is required in patients with massive PE. PE has a high mortality
but the in-hospital all-cause case mortality rates were lower in unstable patients who
received TT than those who did not. However, it was reported that minority (nearly 30%) of
unstable patients received thrombolytic therapy. The reason that majority of unstable
patients failed to receive thrombolytic therapy is unclear. The higher rates of
complications including the life threatening bleeding may be a reason of reluctance in the
use of TT.
The lungs are the only organ receiving the entire cardiac output. Therefore, they are the
point of convergence for the entire molecules of the thrombolytic agent, independent from
the route of administration. So that lower doses of the TT might be effective in PE, with
the additional benefits of enhancing its safety profile. The percutaneous endovenous
intervention for deep venous thrombosis has suggested an exquisitely favorable pulmonary
response to low-dose thrombolysis. The aim of the present study was to assess the effects of
low-dose (25mg) prolonged administration (in 6 hours) of tissue type plasminogen activator
(tPA) on in-hospital mortality and outcomes in patients with massive PE.
The primary end points consisted of in hospital all cause mortality, major complications,
pulmonary hypertension and right ventricular dysfunction. Secondary points are all cause
mortality, pulmonary hypertension and right ventricular dysfunction at 6 month.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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