naa a22 4500 530185385 CHVBK 20181026074444.0 cr unu---uuuuu 181026e201705 xx s 000 0 eng 10.1016/j.amjmed.2016.11.027 doi (SERVAL)BIB_D1318D821C87 28011316 pmid 000402001400044 isiid Treatment of Right Heart Thrombi Associated with Acute Pulmonary Embolism [Elektronische Daten] [D. Barrios, J. Chavant, D. Jiménez, L. Bertoletti, V. Rosa-Salazar, A. Muriel, A. Viallon, C. Fernández-Capitán, R.D. Yusen, M. Monreal, M. Monreal, H. Decousus, P. Prandoni, B. Brenner, R. Barba, P. Di Micco, L. Bertoletti, I. Tzoran, A. Reis, M. Bosevski, H. Bounameaux, R. Malý, P. Wells, P. Verhamme, M.D. Adarraga, M.A. Aibar, M. Alfonso, J.I. Arcelus, P.M. Azcarate-Agüero, A. Ballaz, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, G. Cañada, I. Cañas, I. Casado, N. Chic, R. Del Pozo, J. Del Toro, M.C. Díaz-Pedroche, J.A. Díaz-Peromingo, C. Falgá, C. Fernández-Aracil, C. Fernández-Capitán, M.A. Fidalgo, C. Font, L. Font, P. Gallego, M.A. García, F. García-Bragado, P. García-Brotons, O. Gavín, C. Gómez, V. Gómez, J. González, E. Grau, A. Grimón, L. Guirado, J. Gutiérrez, G. Hernández-Comes, L. Hernández-Blasco, L. Jara-Palomares, M.J. Jaras, D. Jiménez, J. Jiménez, M.D. Joya, P. Llamas, J.L. Lobo, P. López, L. López-Jiménez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, J.M. Luque, P.J. Marchena, C. Martínez, F. Martín-Martos, M. Monreal, J.A. Nieto, S. Nieto, A. Núñez, M.J. Núñez, S. Otalora, R. Otero, J.M. Pedrajas, G. Pérez, C. Pérez-Ductor, M.L. Peris, I. Pons, J.A. Porras, O. Reig, A. Riera-Mestre, D. Riesco, A. Rivas, M. Rodríguez, M.A. Rodríguez-Dávila, V. Rosa, J.C. Sahuquillo, M.C. Sala-Sainz, A. Sampériz, R. Sánchez-Martínez, O. Sanz, S. Soler, B. Sopeña, J.M. Suriñach, C. Tolosa, M.I. Torres, J. Trujillo-Santos, F. Uresandi, E. Usandizaga, B. Valero, R. Valle, J. Vela, G. Vidal, C. Vilar, B. Xifre, T. Vanassche, P. Verhamme, HHB Yoo, P. Wells, J. Hirmerova, R. Malý, E. Salgado, L. Bertoletti, A. Bura-Riviere, D. Farge-Bancel, A. Hij, I. Mahé, A. Merah, F. Moustafa, A. Braester, B. Brenner, I. Tzoran, G. Antonucci, G. Barillari, F. Bilora, A. Bonanome, C. Bortoluzzi, B. Brandolin, M. Ciammaichella, P. De Ciantis, F. Dentali, P. Di Micco, R. Duce, M. Giorgi-Pierfranceschi, E. Grandone, E. Imbalzano, G. Lessiani, R. Maida, D. Mastroiacovo, F. Pace, R. Parisi, R. Pesavento, M. Pinelli, R. Poggio, P. Prandoni, R. Quintavalla, A. Rocci, E. Tiraferri, D. Tonello, A. Tufano, U. Venturelli, A. Visonà, V. Gibietis, A. Skride, B. Vitola, M. Bosevski, M. Zdraveska, H. Bounameaux, L. Mazzolai] Evidence-based recommendations do not adequately address the treatment of right heart thrombi in patients who present with acute symptomatic pulmonary embolism. This study included patients who had acute pulmonary embolism associated with right heart thrombi and participated in the Registro Informatizado de la Enfermedad TromboEmbólica registry. We assessed the effectiveness of anticoagulation versus reperfusion treatment for the outcomes of all-cause mortality, pulmonary embolism-related mortality, recurrent venous thromboembolism, and major bleeding rates through 30 days after initiation of pulmonary embolism treatment. We used propensity score matching to adjust for the likelihood of receiving reperfusion treatment. Of 325 patients with pulmonary embolism and right heart thrombi, 255 (78%; 95% confidence interval, 74-83) received anticoagulation and 70 (22%; 95% confidence interval, 17-26) also received reperfusion treatment. Propensity score-matched pairs analyses did not detect a statistically lower risk of all-cause death (6.2% vs 14%, P= .15) or pulmonary embolism-related mortality (4.7% vs 7.8%; P= .47) for reperfusion compared with anticoagulation. Of the patients who received reperfusion treatment, 6.2% had a recurrence during the study follow-up period, compared with 0% of those who received anticoagulation (P= .049). The incidence of major bleeding events was not statistically different between the 2 treatment groups (3.1% vs 3.1%; P= 1.00). In patients with pulmonary embolism and right heart thrombi, no significant difference was found between reperfusion therapy and anticoagulant therapy for mortality and bleeding. The risk of recurrences was significantly higher for reperfusion therapy compared with anticoagulation. Right heart thrombi may not warrant riskier interventions than standard anticoagulation. Barrios D. aut Chavant J. aut Jiménez D. aut Bertoletti L. aut Rosa-Salazar V. aut Muriel A. aut Viallon A. aut Fernández-Capitán C. aut Yusen R.D. aut Monreal M. aut Monreal M. Decousus H. Prandoni P. Brenner B. Barba R. Di Micco P. Bertoletti L. Tzoran I. Reis A. Bosevski M. Bounameaux H. Malý R. Wells P. Verhamme P. Adarraga M.D. Aibar M.A. Alfonso M. Arcelus J.I. Azcarate-Agüero P.M. Ballaz A. Barrón M. Barrón-Andrés B. Bascuñana J. Blanco-Molina A. Cañada G. Cañas I. Casado I. Chic N. Del Pozo R. Del Toro J. Díaz-Pedroche M.C. Díaz-Peromingo J.A. Falgá C. Fernández-Aracil C. Fernández-Capitán C. Fidalgo M.A. Font C. Font L. Gallego P. García M.A. García-Bragado F. García-Brotons P. Gavín O. Gómez C. Gómez V. González J. Grau E. Grimón A. Guirado L. Gutiérrez J. Hernández-Comes G. Hernández-Blasco L. Jara-Palomares L. Jaras M.J. Jiménez D. Jiménez J. Joya M.D. Llamas P. Lobo J.L. López P. López-Jiménez L. López-Reyes R. López-Sáez J.B. Lorente M.A. Lorenzo A. Luque J.M. Marchena P.J. Martínez C. Martín-Martos F. Nieto J.A. Nieto S. Núñez A. Núñez M.J. Otalora S. Otero R. Pedrajas J.M. Pérez G. Pérez-Ductor C. Peris M.L. Pons I. Porras J.A. Reig O. Riera-Mestre A. Riesco D. Rivas A. Rodríguez M. Rodríguez-Dávila M.A. Rosa V. Sahuquillo J.C. Sala-Sainz M.C. Sampériz A. Sánchez-Martínez R. Sanz O. Soler S. Sopeña B. Suriñach J.M. Tolosa C. Torres M.I. Trujillo-Santos J. Uresandi F. Usandizaga E. Valero B. Valle R. Vela J. Vidal G. Vilar C. Xifre B. Vanassche T. Yoo HHB Hirmerova J. Salgado E. Bura-Riviere A. Farge-Bancel D. Hij A. Mahé I. Merah A. Moustafa F. Braester A. Antonucci G. Barillari G. Bilora F. Bonanome A. Bortoluzzi C. Brandolin B. Ciammaichella M. De Ciantis P. Dentali F. Duce R. Giorgi-Pierfranceschi M. Grandone E. Imbalzano E. Lessiani G. Maida R. Mastroiacovo D. Pace F. Parisi R. Pesavento R. Pinelli M. Poggio R. Quintavalla R. Rocci A. Tiraferri E. Tonello D. Tufano A. Venturelli U. Visonà A. Gibietis V. Skride A. Vitola B. Zdraveska M. Mazzolai L. The American journal of medicine 130/5(2017-05), 588-595 130:5<588-595 2017 130 1 article serval SERVAL 700 1- Barrios D. aut SERVAL 700 1- Chavant J. aut SERVAL 700 1- Jiménez D. aut SERVAL 700 1- Bertoletti L. aut SERVAL 700 1- Rosa-Salazar V. aut SERVAL 700 1- Muriel A. aut SERVAL 700 1- Viallon A. aut SERVAL 700 1- Fernández-Capitán C. aut SERVAL 700 1- Yusen R.D. aut SERVAL 700 1- Monreal M. aut SERVAL 700 1- Monreal M. SERVAL 700 1- Decousus H. SERVAL 700 1- Prandoni P. SERVAL 700 1- Brenner B. SERVAL 700 1- Barba R. SERVAL 700 1- Di Micco P. SERVAL 700 1- Bertoletti L. SERVAL 700 1- Tzoran I. SERVAL 700 1- Reis A. SERVAL 700 1- Bosevski M. SERVAL 700 1- Bounameaux H. SERVAL 700 1- Malý R. SERVAL 700 1- Wells P. SERVAL 700 1- Verhamme P. SERVAL 700 1- Adarraga M.D. SERVAL 700 1- Aibar M.A. SERVAL 700 1- Alfonso M. SERVAL 700 1- Arcelus J.I. SERVAL 700 1- Azcarate-Agüero P.M. SERVAL 700 1- Ballaz A. SERVAL 700 1- Barrón M. SERVAL 700 1- Barrón-Andrés B. SERVAL 700 1- Bascuñana J. SERVAL 700 1- Blanco-Molina A. SERVAL 700 1- Cañada G. SERVAL 700 1- Cañas I. SERVAL 700 1- Casado I. SERVAL 700 1- Chic N. SERVAL 700 1- Del Pozo R. SERVAL 700 1- Del Toro J. SERVAL 700 1- Díaz-Pedroche M.C. SERVAL 700 1- Díaz-Peromingo J.A. SERVAL 700 1- Falgá C. SERVAL 700 1- Fernández-Aracil C. SERVAL 700 1- Fernández-Capitán C. SERVAL 700 1- Fidalgo M.A. SERVAL 700 1- Font C. SERVAL 700 1- Font L. SERVAL 700 1- Gallego P. SERVAL 700 1- García M.A. SERVAL 700 1- García-Bragado F. SERVAL 700 1- García-Brotons P. SERVAL 700 1- Gavín O. SERVAL 700 1- Gómez C. SERVAL 700 1- Gómez V. SERVAL 700 1- González J. SERVAL 700 1- Grau E. SERVAL 700 1- Grimón A. SERVAL 700 1- Guirado L. SERVAL 700 1- Gutiérrez J. SERVAL 700 1- Hernández-Comes G. SERVAL 700 1- Hernández-Blasco L. SERVAL 700 1- Jara-Palomares L. SERVAL 700 1- Jaras M.J. SERVAL 700 1- Jiménez D. SERVAL 700 1- Jiménez J. SERVAL 700 1- Joya M.D. SERVAL 700 1- Llamas P. SERVAL 700 1- Lobo J.L. SERVAL 700 1- López P. SERVAL 700 1- López-Jiménez L. SERVAL 700 1- López-Reyes R. SERVAL 700 1- López-Sáez J.B. SERVAL 700 1- Lorente M.A. SERVAL 700 1- Lorenzo A. SERVAL 700 1- Luque J.M. SERVAL 700 1- Marchena P.J. SERVAL 700 1- Martínez C. SERVAL 700 1- Martín-Martos F. SERVAL 700 1- Nieto J.A. SERVAL 700 1- Nieto S. SERVAL 700 1- Núñez A. SERVAL 700 1- Núñez M.J. SERVAL 700 1- Otalora S. SERVAL 700 1- Otero R. SERVAL 700 1- Pedrajas J.M. SERVAL 700 1- Pérez G. SERVAL 700 1- Pérez-Ductor C. SERVAL 700 1- Peris M.L. SERVAL 700 1- Pons I. SERVAL 700 1- Porras J.A. SERVAL 700 1- Reig O. SERVAL 700 1- Riera-Mestre A. SERVAL 700 1- Riesco D. SERVAL 700 1- Rivas A. SERVAL 700 1- Rodríguez M. SERVAL 700 1- Rodríguez-Dávila M.A. SERVAL 700 1- Rosa V. SERVAL 700 1- Sahuquillo J.C. SERVAL 700 1- Sala-Sainz M.C. SERVAL 700 1- Sampériz A. SERVAL 700 1- Sánchez-Martínez R. SERVAL 700 1- Sanz O. SERVAL 700 1- Soler S. SERVAL 700 1- Sopeña B. SERVAL 700 1- Suriñach J.M. SERVAL 700 1- Tolosa C. SERVAL 700 1- Torres M.I. SERVAL 700 1- Trujillo-Santos J. SERVAL 700 1- Uresandi F. SERVAL 700 1- Usandizaga E. SERVAL 700 1- Valero B. SERVAL 700 1- Valle R. SERVAL 700 1- Vela J. SERVAL 700 1- Vidal G. SERVAL 700 1- Vilar C. SERVAL 700 1- Xifre B. SERVAL 700 1- Vanassche T. SERVAL 700 1- Yoo HHB SERVAL 700 1- Hirmerova J. SERVAL 700 1- Salgado E. SERVAL 700 1- Bura-Riviere A. SERVAL 700 1- Farge-Bancel D. SERVAL 700 1- Hij A. SERVAL 700 1- Mahé I. SERVAL 700 1- Merah A. SERVAL 700 1- Moustafa F. SERVAL 700 1- Braester A. SERVAL 700 1- Antonucci G. SERVAL 700 1- Barillari G. SERVAL 700 1- Bilora F. SERVAL 700 1- Bonanome A. SERVAL 700 1- Bortoluzzi C. SERVAL 700 1- Brandolin B. SERVAL 700 1- Ciammaichella M. SERVAL 700 1- De Ciantis P. SERVAL 700 1- Dentali F. SERVAL 700 1- Duce R. SERVAL 700 1- Giorgi-Pierfranceschi M. SERVAL 700 1- Grandone E. SERVAL 700 1- Imbalzano E. SERVAL 700 1- Lessiani G. SERVAL 700 1- Maida R. SERVAL 700 1- Mastroiacovo D. SERVAL 700 1- Pace F. SERVAL 700 1- Parisi R. SERVAL 700 1- Pesavento R. SERVAL 700 1- Pinelli M. SERVAL 700 1- Poggio R. SERVAL 700 1- Quintavalla R. SERVAL 700 1- Rocci A. SERVAL 700 1- Tiraferri E. SERVAL 700 1- Tonello D. SERVAL 700 1- Tufano A. SERVAL 700 1- Venturelli U. SERVAL 700 1- Visonà A. SERVAL 700 1- Gibietis V. SERVAL 700 1- Skride A. SERVAL 700 1- Vitola B. SERVAL 700 1- Zdraveska M. SERVAL 700 1- Mazzolai L. SERVAL 773 0- The American journal of medicine 130/5(2017-05), 588-595 130:5<588-595 2017 130 BK010053 XK010053 XK010000 SERVAL SERVAL SERVAL article