CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC 2022 17_9-10_29210.15836/ccar2022.292Extended AbstractAcute and intensive cardiologySystemic thrombolytic therapy in patients with intermediate-high-risk pulmonary embolismhttps://orcid.org/0000-0003-0684-6333GolubićKarlo*https://orcid.org/0000-0001-8829-2543KosNikolahttps://orcid.org/0000-0002-8431-6963BatinićTonćihttps://orcid.org/0000-0002-8432-404XVrsalovićMislavSestre Milosrdnice University Hospital Centre, Zagreb, CroatiaADDRESS FOR CORRESPONDENCE: Karlo Golubić, Klinički bolnički centar Sestre milosrdnice, Vinogradska cesta 29, HR-10000 Zagreb, Croatia. / Phone: +385-99-3787-165 / E-mail: karlo.golubic@kbcsm.hr112022179-1029229204112022101120222022Croatian Cardiac SocietyKEYWORDS: pulmonary embolismthrombolytic therapy
Pulmonary embolism remains the one of the commonest cardiovascular disease, the severity of which is variable and can be lethal. The incidence is expected to increase due to the aging population. Intermediate-high risk pulmonary embolism is characterized by hemodynamical stability, but elevated mortality risk and both radiographic and laboratory signs of right heart strain. Thrombolysis remains a possible life saving treatment option but bears an increased risk of potentially life-threatening hemorrhage. Optimal treatment is still not established. (1-3) We present a series of intermediate-high risk patients treated in our hospital with thrombolytic therapy (n=4, 2 male, median age 58.5) and compare relevant direct and indirect values of right ventricular load before and after treatment (Table 1). We also provide a summary of our clinical approach in light of current guidelines and two meta-analyses.
Comparison of relevant direct and indirect values of right ventricular load before and after treatment.
Before treatment
After treatment
SO2 (%)
TnI (ng/L)
NTproBNP (ng/L)
SO2 (%)
TnI (ng/L)
NTproBNP (ng/L)
80
657
6103
98
35
83
82
61
3522
92
<10
145
84
190
9122
97
262
2976
94
125
2597
96
<10
139
LITERATUREKonstantinidesSVMeyerGBecattiniCBuenoHGeersingGJHarjolaVPESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). . 2020 January 21;41(4):543–603. 10.1093/eurheartj/ehz40531504429ChatterjeeSChakrabortyAWeinbergIKadakiaMWilenskyRLSardarPThrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. . 2014 June 18;311(23):2414–21. 10.1001/jama.2014.599024938564ZuoZYueJDongBRWuTLiuGJThrombolytic therapy for pulmonary embolism. . 2021 April 15;4(4):CD004437. 10.1002/14651858.CD004437.pub633857326