Clinical & Experimental Cardiology
Open Access

Efficacy and safety of tenecteplase with standard anticoagulation therapy versus standard anticoagulation therapy alone for sub massive or intermediate-risk pulmonary embolism: A metaanalysis

6^th International Conference on Clinical & Experimental Cardiology

November 30-December 02, 2015 San Antonio, USA

Lea Arceli G Porciuncula and Evelyn A Esposo

St. Luke�s Medical Center, Philippines

Posters-Accepted Abstracts: J Clin Exp Cardiolog

Abstract :

Objectives: To determine the efficacy and safety of tenecteplase with anticoagulation versus anticoagulation alone in patients with intermediate-risk Pulmonary Embolism (PE) in reducing all-cause mortality, respiratory distress requiring Mechanical Ventilation (MV), recurrence of PE and major bleeding episodes. Design: Meta-analysis including three RCTs. Setting: Studies included were performed in Italian, German, and American medical centers. Participants: Inclusion criteria: adult patients diagnosed with PE with RV dysfunction on echocardiogram or CT scan with stable hemodynamic status. Exclusion criteria: hemodynamic instability, history of bleeding, and contraindication to anticoagulants. Interventions: Weight-based tenecteplase with anticoagulation versus anticoagulation alone. Main Outcome Measures: Efficacy outcome measures: reduction in all-cause mortality, respiratory distress requiring MV and recurrence of PE; Safety outcome parameter: major bleeding episodes. Results: There is no statistically significant difference for death from any cause (Z=0.89, pvalue0.37), however, there is a trend favoring tenecteplase group (OR0.65, CI0.26-1.66). There is also no statistically significant difference for reduction in respiratory distress requiring MV and recurrence of PE, but there is a trend favoring tenecteplase group. In terms of major bleeding, there is a statistically significant difference, favoring placebo (OR4.91, CI2.68-8.97). Conclusion: There is a trend favoring tenecteplase in intermediate-risk PE in terms of all-cause mortality, respiratory distress requiring mechanical ventilation and recurrence of PE, however, with increased rate of major bleeding.

Biography :

Lea Arceli G. Porciuncula is at the age of 30 years from St. Luke’s Medical Center, E. Rodriguez Avenue, Quezon City, Philippines. She is currently training as a second year clinical fellow in cardiology in the HB Calleja Heart and Vascular Institute.

Email: lea.gonzales@yahoo.com