Abstract :Abstract
Background: Thrombolytics are recommended in high risk patients with massive pulmonary embolism (PE). However, clinical practice seems to be far different and questions related to its utility in lesser severe patients remain subject of investigation. The objective of this retrospective study was to compare the efficacy and safety of tenecteplase with streptokinase and heparin.
Method: A total of 103 patients (tenecteplase: 62, streptokinase: 17, heparin: 24) diagnosed with PE (massive: 33[32.04%], submassive: 50[48.54%] and minor: 20[19.42%]) were included.
Results: Mean age was 50.04 years and major risk factors were immobilization due to hospitalization, history of deep vein thrombosis and diabetes. Common clinical symptoms of dyspnoea, right ventricular dysfunction and cough were found in 94.17, 81.55 and 77.67% patients, respectively. Between treatment and day 7 death occurred in 4.84, 5.88 and 8.33% patients in the tenecteplase, streptokinase and heparin group, respectively. The difference between treatment group was nonsignificant (p>0.05). All treatment have shown significant alleviation in the dyspnoea and heart rate (p<0.05). Significant (p<0.05) increase in the oxygen saturation was seen and it was markedly higher in the tenecteplase treated patients compared with the streptokinase and heparin. By day 7, there was 100% resolution of right bundle branch block only in the tenecteplase group. No intracranial bleeding or fatal bleeding episode was found in either group.