CERTIFICATE

IMPACT FACTOR 2021

Subject Area

  • Life Sciences / Biology
  • Architecture / Building Management
  • Asian Studies
  • Business & Management
  • Chemistry
  • Computer Science
  • Economics & Finance
  • Engineering / Acoustics
  • Environmental Science
  • Agricultural Sciences
  • Pharmaceutical Sciences
  • General Sciences
  • Materials Science
  • Mathematics
  • Medicine
  • Nanotechnology & Nanoscience
  • Nonlinear Science
  • Chaos & Dynamical Systems
  • Physics
  • Social Sciences & Humanities

Why Us? >>

  • Open Access
  • Peer Reviewed
  • Rapid Publication
  • Life time hosting
  • Free promotion service
  • Free indexing service
  • More citations
  • Search engine friendly

Noacs or warfarin after thrombolysis for the treatment of acute intermediate-high riskpulmonary embolism: no-war study

Author: 
Sergio Fasullo, Giorgio Maringhini, Sebastiano Scalzo and Filippo Ganci
Subject Area: 
Health Sciences
Abstract: 

Aims: Thrombolysis and anticoagulation were the main treatment methods for acute pulmonary embolism. Anticoagulation therapy is recommended in the guidelines for patients with intermediate-low and low-risk PE, and emergency thrombolysis is recommended for high-risk or massive PE, in order to stabilize hemodynamics and reduce early mortality. Warfarin has been the anticoagulant of choice for pulmonary embolismHowever, there remains controversy about the treatment of acute intermediate-high-risk PE.Novel oral anticoagulants (NOACs) are increasingly used as an alternative. The study was aimed at assessing efficacy and safety of new oral anticoagulants (NOACs) after thrombolysis versus warfarin treatment on echocardiographic parameters and clinical outcome during hospitalization and in six mounth after admission, in patients with acute intermediate-high-Risk Pulmonary Embolism. Although the use of thrombolysis has been investigated in these patients, anticoagulation remains the standard treatment approach. Rivaroxaban and apixaban have shown similar efficacy and, in some cases, reduced major bleeding compared with standard approaches for acute treatment. The direct oral anticoagulants do not require regular coagulation monitoring. Methods: Consecutive patients (study court: age 42-85 years), with a episode acute pulmonary embolism,with onset of symptoms since no more than 6 hours, normal blood pressure ( >95 mmHg), right ventricle dysfunction (RVD) at echocardiography and positive lung spiral CT were in double blind fashion randomized: a group received 100 mg of alteplase (10-mg bolus, followed by a 90-mg i.v. infusion over a period of 2 hours) and warfarin after 48-72 h in according with INR target , and a group received 100 mg of alteplase (10-mg bolus, followed by a 90-mg i.v. infusion over a period of 2 hours) and NOACs (rivaroxaban or apixaban on randomization 1:1) after 48-72 h. In addition to alteplase , both groups received unfractionated heparin treatment for 48 h. Echocardiogram was performed at entry and 48 or 72, discharge and 6 months after randomization. Results: 44 patients were included in the study, 22 assigned to warfarin and 22 to NAOCs. The 2 groups were well matched with regard to features and clinical presentation. NAOCs group showed an safety and a reduction in clinical events during hospitalization and follow up was also observed. Conclusions: Our data suggest that NOACs after thrombolysis a favorable trend in clinical outcome and could merit consideration in patients with acute intermediate-high-Risk Pulmonary Embolism. The new anticoagulation have been shown to reduce the risk of recurrent venous thromboembolism when given for 6 months. This use after thrombolysis, at this time, is off‑label and should could be considered and included in the new guidelines.

PDF file: 

CALL FOR PAPERS

 

ONLINE PAYPAL PAYMENT

IJMCE RECOMMENDATION

Advantages of IJCR

  • Rapid Publishing
  • Professional publishing practices
  • Indexing in leading database
  • High level of citation
  • High Qualitiy reader base
  • High level author suport

Plagiarism Detection

IJCR is following an instant policy on rejection those received papers with plagiarism rate of more than 20%. So, All of authors and contributors must check their papers before submission to making assurance of following our anti-plagiarism policies.

 

EDITORIAL BOARD

CHUDE NKIRU PATRICIA
Nigeria
Dr. Swamy KRM
India
Dr. Abdul Hannan A.M.S
Saudi Arabia.
Luai Farhan Zghair
Iraq
Hasan Ali Abed Al-Zu’bi
Jordanian
Fredrick OJIJA
Tanzanian
Firuza M. Tursunkhodjaeva
Uzbekistan
Faraz Ahmed Farooqi
Saudi Arabia
Eric Randy Reyes Politud
Philippines
Elsadig Gasoom FadelAlla Elbashir
Sudan
Eapen, Asha Sarah
United State
Dr.Arun Kumar A
India
Dr. Zafar Iqbal
Pakistan
Dr. SHAHERA S.PATEL
India
Dr. Ruchika Khanna
India
Dr. Recep TAS
Turkey
Dr. Rasha Ali Eldeeb
Egypt
Dr. Pralhad Kanhaiyalal Rahangdale
India
DR. PATRICK D. CERNA
Philippines
Dr. Nicolas Padilla- Raygoza
Mexico
Dr. Mustafa Y. G. Younis
Libiya
Dr. Muhammad shoaib Ahmedani
Saudi Arabia
DR. MUHAMMAD ISMAIL MOHMAND
United State
DR. MAHESH SHIVAJI CHAVAN
India
DR. M. ARUNA
India
Dr. Lim Gee Nee
Malaysia
Dr. Jatinder Pal Singh Chawla
India
DR. IRAM BOKHARI
Pakistan
Dr. FARHAT NAZ RAHMAN
Pakistan
Dr. Devendra kumar Gupta
India
Dr. ASHWANI KUMAR DUBEY
India
Dr. Ali Seidi
Iran
Dr. Achmad Choerudin
Indonesia
Dr Ashok Kumar Verma
India
Thi Mong Diep NGUYEN
France
Dr. Muhammad Akram
Pakistan
Dr. Imran Azad
Oman
Dr. Meenakshi Malik
India
Aseel Hadi Hamzah
Iraq
Anam Bhatti
Malaysia
Md. Amir Hossain
Bangladesh
Ahmet İPEKÇİ
Turkey
Mirzadi Gohari
Iran