This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (3)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Thrombolysis  • Venous Thromboembolism  • Cardiovascular System  • Alert me on articles by topic  Social Bookmarking   What's this?

Samuel Z. Goldhaber, MD

Arch Intern Med. 2005;165:2204.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The opposition to thrombolysis by Thabut and Logeart is based on their fundamental miscalculation that the mortality from acute PE is only 1.5%. The death rate from acute PE is actually 10-fold higher (15%) when consecutive patients with PE are tracked.¹ Thabut and Logeart were also misled by reading only sanitized clinical trials with dozens of exclusion criteria. These trials skim off the healthiest segment of the PE population. Physicians who evaluate patients in the emergency department or intensive care unit recognize that PE is more deadly than acute myocardial infarction.

Meta-analyses of patients with PE show a 33% reduction of death and recurrent PE with thrombolysis.² The same overviews demonstrate an increase in bleeding complications. But the meta-analyses cannot place a value on benefit vs risk. This is our task as treating physicians.

As Thabut and Logeart state, RV dysfunction may reflect an ill population . . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Thrombolytic Therapy for Patients With Pulmonary Embolism Who Are Hemodynamically Stable But Have Right Ventricular Dysfunction: Pro
Samuel Z. Goldhaber
Arch Intern Med. 2005;165(19):2197-2199.
EXTRACT | FULL TEXT  

Thrombolysis for Pulmonary Embolism in Patients With Right Ventricular Dysfunction: Con
Gabriel Thabut and Damien Logeart
Arch Intern Med. 2005;165(19):2200-2203.
EXTRACT | FULL TEXT  

Rebuttal
Gabriel Thabut and Damien Logeart
Arch Intern Med. 2005;165(19):2204-2205.
EXTRACT | FULL TEXT