Comparision of side effects between thrombolytic and anticoagulation therapy in patients with Pulmonary Embolism

Abstract

Purpose: The treatment of Pulmonary Embolism (PE) which is life threatening disease must be planned considering risk – benefit relationship. In this study, patients with PE given thrombolytic therapy, low-molecular-weight heparin and warfarin were monitored for 5 years to compare them in terms of hemorrhage side effect due to therapy.

Method: A total of 219 patients were included in the study. 50.2% (n=109) of the patient’s were female and 49.8% (n=110) were male, (p=0.20). Clinical findings, radiologic and laboratory parameters were recorded retrospectively. A total of 121 (55.25%) patients were given thrombolytic therapy (Group 1 n=121). Enoxaparin therapy was given to 205 patients (Group 2). During therapy maintenance, warfarin therapy conducted for 159 patients (Group 3).

Results: Cerebral hemorrhage observed in 1 case (0.83%) in group 1, 2 case (0.98%) in group 2 and 1 case (0.62%) in group 3 (p>0.05). Gastrointestinal system (GI) bleeding happened 2 cases (1.65%) in group 1 and 2 cases (0.98%) in group 2 (p>0.05). Minor bleeding was observed at similar rates due to the treatments. There was no fatality due to hemorrhage. There is no significant difference in terms of death, recurrence, residuel chronic thrombus and chronic PE in the follow up for five years between rt-PA group (group1) and non rt-PA group (p>0.05).

Conclusion: According to our results; major hemorrhage observed similar in thrombolytic, enoxaparin and warfarin therapy. Study results about the rate of cerebral hemorrhage related to thrombolytic therapy was low in contrast to the results reported in some literature before.