Comparison of the use of alteplase infusions with bolus-dose alteplase in the treatment of massive pulmonary embolism (PE)
| Study or subcategory | Alteplase infusion n/N | Alteplase bolus n/N | Weight % | Fixed RR (95% CI) |
| All-cause mortality# | ||||
| Goldhaber et al. 20 | 1/27 | 5/60 | 100 | 0.44 (0.05–3.62) |
| Sors et al. 19 | 0/17 | 0/36 | NE | |
| Subtotal## | 44 | 96 | 100 | 0.44 (0.05–3.62) |
| Deaths due to bleeding¶ | ||||
| Goldhaber et al. 20 | 0/27 | 2/60 | 100 | 0.44 (0.02–8.78) |
| Sors et al. 19 | 0/17 | 0/36 | NE | |
| Subtotal## | 44 | 96 | 100 | 0.44 (0.02–8.78) |
| Deaths due to recurrent PE+ | ||||
| Goldhaber et al. 20 | 1/27 | 3/60 | 100 | 0.74 (0.08–6.80) |
| Sors et al. 19 | 0/17 | 0/36 | NE | |
| Subtotal## | 44 | 96 | 100 | 0.74 (0.08–6.80) |
| Major bleeding episodes§ | ||||
| Goldhaber et al. 20 | 6/27 | 8/60 | 33.21 | 1.67 (0.64–4.34) |
| Sors et al. 19 | 1/17 | 3/36 | 12.87 | 0.71 (0.08–6.30) |
| Meyer et al. 23 | 5/19 | 28/113 | 53.91 | 1.06 (0.47–2.41) |
| Subtotal## | 63 | 209 | 100 | 1.22 (0.67–2.21) |
| Recurrent PEƒ | ||||
| Goldhaber et al. 20 | 2/27 | 4/60 | 65.93 | 1.11 (0.22–5.70) |
| Sors et al. 19 | 1/17 | 2/36 | 34.07 | 1.06 (0.10–10.88) |
| Subtotal## | 44 | 96 | 100 | 1.09 (0.29–4.17) |
RR: relative risk; CI: confidence interval; NE: not estimable. #: total events, 1 (alteplase infusion), 5 (alteplase bolus); test for heterogeneity, not applicable; test for overall effect, z = 0.76, p = 0.45. ¶: total events, 0 (alteplase infusion), 2 (alteplase bolus); test for heterogeneity, not applicable; test for overall effect, z = 0.54, p = 0.59. +: total events, 1 (alteplase infusion), 3 (alteplase bolus); test for heterogeneity, not applicable; test for overall effect, z = 0.27, p = 0.79. §: total events, 12 (alteplase infusion), 39 (alteplase bolus); test for heterogeneity, Chi-squared = 0.76, df = 2 (p = 0.68), l2 = 0%; test for overall effect, z = 0.65, p = 0.52. ƒ: total events, 3 (alteplase infusion), 6 (alteplase bolus); test for heterogeneity, Chi-squared = 0.00, df = 1 (p = 0.97), l2 = 0%; test for overall effect, z = 0.13, p = 0.90. ##: 95% CI.