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Rebuttal
Samuel Z. Goldhaber, MD
Arch Intern Med. 2005;165:2204.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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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]
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Gabriel Thabut and Damien Logeart
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Rebuttal
Gabriel Thabut and Damien Logeart
Arch Intern Med. 2005;165(19):2204-2205.
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