PE study characteristics
| References . | Treatment (no. of participants) . | Mean age, y . | Females in study, % . | PE characteristics . | Thrombolytic scheme . | Infusion type . |
|---|---|---|---|---|---|---|
| Becattini et al14 | Thrombolytic plus UFH (n = 28); placebo plus UFH (n = 30) | 68 | 39.1 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Tenecteplase 30-50 mg (bolus) | Systemic |
| Dalla-Volta et al15 | Thrombolytic plus UFH (n = 20); UFH alone (n = 16) | 65 | 66.6 | Acute PE (any) without systolic hypotension | rt-PA 100 mg (bolus + 2-h infusion) | Systemic |
| Dotter et al16 | Thrombolytic plus UFH (n = 15); UFH alone (n = 16) | Range, 18-85 | 61.3 | Acute PE (any) without systolic hypotension | Streptokinase 2 550 000-11 450 000 IU (bolus + 18- to 72-h infusion) | Systemic |
| Fasullo et al17 | Thrombolytic plus UFH (n = 37); placebo plus UFH (n = 35) | 56 | 51.3 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 100 mg (bolus + 2-h infusion) | Systemic |
| Goldhaber et al18 | Thrombolytic plus UFH (n = 46); UFH alone (n = 55) | 59 | 56.4 | Acute PE (any) without systolic hypotension; 45.5% had submassive- or intermediate-risk PE defined as RV hypokinesis (echocardiography) | rt-PA 100 mg (2-h infusion) | Systemic |
| Jerjes-Sanchez et al19 | Thrombolytic plus UFH (n = 4); UFH alone (n = 4) | 48 | 37.5 | Acute massive PE defined as >9 obstructed segments on V/Q lung scan with or without cardiogenic shock (systolic BP <90 mmHg) (all included patients had cardiogenic shock) | Streptokinase 1 500 000 IU (1-h infusion) | Systemic |
| Kline et al20 | Thrombolytic plus LMWH (n = 40); heparin plus LMWH (n = 43) | 55 | 39.7 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) or myocardial injury (BNP) without systolic hypotension | Tenecteplase 30-50 mg (bolus) | Systemic |
| Kostantinides et al21 | Thrombolytic plus UFH (n = 118); placebo plus UFH (n = 138) | 62 | 52.3 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 100 mg (bolus + 2-h infusion) | Systemic |
| Kucher et al22 | Thrombolytic plus UFH (n = 30); UFH alone (n = 29) | 63 | 49.1 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 10-20 mg (15-h infusion) | Directed (ultrasound assisted) |
| Levine et al23 | Thrombolytic plus UFH (n = 33); placebo plus UFH (n = 25) | 61 | 50.0 | Acute PE (any) without systolic hypotension | rt-PA 0.6 mg/kg ideal body weight (bolus) | Systematic |
| Liu et al24 | Thrombolytic plus LMWH (n = 30); LMWH alone (n = 24) | 58.2 | No significant differences between sexes | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 50 mg (bolus) | Systemic |
| Lu et al25 | Thrombolytic plus LMWH (n = 51); LMWH alone (n = 55) | 60.8 | 25.5 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Urokinase 20 000 IU/kg (bolus) | Systemic |
| Ly et al26 | Thrombolytic plus UFH (n = 14); UFH alone (n = 10) | 53.2 | 56 | Acute PE (any) without systolic hypotension. | Streptokinase 7 450 000 IU (bolus + 72-h infusion) | Systemic |
| Meyer et al27 | Thrombolytic plus UFH (n = 506); placebo plus UFH (n = 499) | 66.2 | 52.9 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography or CT) plus myocardial injury (troponin) without systolic hypotension | Tenecteplase 30-50 mg (bolus) | Systemic |
| PIOPED28 | Thrombolytic plus UFH (n = 9); placebo plus heparin (n = 4) | 58.5 | 30.8 | Acute PE (any) without systolic hypotension. | rt-PA 40-80 mg (40- to 90-min infusion) | Systemic |
| Sharifi et al29 | Thrombolytic plus UFH (n = 61); UFH alone (n = 60) | 58.5 | 54.5 | Acute submassive- or intermediate-risk PE clinically defined (chest pain, tachypnea, tachycardia, dyspnea, cough oxygen desaturation or elevated venous pressure) or RVD (echocardiography) or myocardial injury (troponin or BNP) without systolic hypotension | rt-PA 50 mg (bolus + 2-h infusion) | Systemic |
| Sun30 | Thrombolytic plus LMWH (n = 46); LMWH alone (n = 46) | 56.3 | 44.6 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Urokinase 500 000 IU (bolus) | Systemic |
| Taherkhani et al31 | Thrombolytic plus UFH (n = 25); UFH alone (n = 25) | 55.7 | 60 | Acute submassive- or intermediate-risk PE defined as RVD or enlargement (echocardiography) without systolic hypotension | rt-PA 100 mg (90-min infusion) or streptokinase 1 500 000 (2-h infusion) | Systemic |
| Tibutt et al32 | Thrombolytic (n = 13); UFH (n = 17) | 48.7 | 50 | Acute PE (any); mean systolic BP 108 mmHg | Streptokinase 600 000 IU (bolus + 72-h infusion) | Infused in the pulmonary artery |
| UKEP33 | Thrombolytic (n = 82); UFH (n = 78) | 49.4% >50 y* | 42.5 | Acute PE (any); 8.7% with hemodynamic compromise | Urokinase 2 000 (12-h infusion); 4 400 IU/kg (24-h infusion) | Infused in the pulmonary artery |
| Wei and Sun34 | Thrombolytic (n = 28); LMWH (n = 28); 2 lost to follow-up in the control group | 58 | 40.0 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 50 mg (bolus) | Systemic |
| Zhang et al35 | Thrombolytic (n = 26); LMWH (n = 29) | 68 | 41.8 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 50 mg (bolus) | Systemic |
| Ou36 | Thrombolytic (n = 54); UFH (n = 54) | 58.3 | 28.7 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Urokinase 20 000 IU/kg (bolus) | Systemic |
| Marini et al37 | Thrombolytic (n = 20); UFH (n = 10) | 53 | 40.0 | Acute PE (any) without systolic hypotension. | Urokinase 2 400 000 IU (36-h infusion) | Systemic |
| Ahmed et al38 | Thrombolytic (n = 24); UFH (n = 28) | 44.7 | 53.8 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) or myocardial injury (troponin or BNP) without systolic hypotension | Streptokinase 1 500 000 IU (2-h infusion) | Systemic |
| Zhang et al39 | Thrombolytic (n = 33); LMWH (n = 33) | 59.5 | 51.5 | Acute intermediate-risk PE defined as RVD (echocardiography) or myocardial injury (troponin or BNP) without systolic hypotension | rt-PA 30 mg (2-h infusion) | Systemic |
| References . | Treatment (no. of participants) . | Mean age, y . | Females in study, % . | PE characteristics . | Thrombolytic scheme . | Infusion type . |
|---|---|---|---|---|---|---|
| Becattini et al14 | Thrombolytic plus UFH (n = 28); placebo plus UFH (n = 30) | 68 | 39.1 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Tenecteplase 30-50 mg (bolus) | Systemic |
| Dalla-Volta et al15 | Thrombolytic plus UFH (n = 20); UFH alone (n = 16) | 65 | 66.6 | Acute PE (any) without systolic hypotension | rt-PA 100 mg (bolus + 2-h infusion) | Systemic |
| Dotter et al16 | Thrombolytic plus UFH (n = 15); UFH alone (n = 16) | Range, 18-85 | 61.3 | Acute PE (any) without systolic hypotension | Streptokinase 2 550 000-11 450 000 IU (bolus + 18- to 72-h infusion) | Systemic |
| Fasullo et al17 | Thrombolytic plus UFH (n = 37); placebo plus UFH (n = 35) | 56 | 51.3 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 100 mg (bolus + 2-h infusion) | Systemic |
| Goldhaber et al18 | Thrombolytic plus UFH (n = 46); UFH alone (n = 55) | 59 | 56.4 | Acute PE (any) without systolic hypotension; 45.5% had submassive- or intermediate-risk PE defined as RV hypokinesis (echocardiography) | rt-PA 100 mg (2-h infusion) | Systemic |
| Jerjes-Sanchez et al19 | Thrombolytic plus UFH (n = 4); UFH alone (n = 4) | 48 | 37.5 | Acute massive PE defined as >9 obstructed segments on V/Q lung scan with or without cardiogenic shock (systolic BP <90 mmHg) (all included patients had cardiogenic shock) | Streptokinase 1 500 000 IU (1-h infusion) | Systemic |
| Kline et al20 | Thrombolytic plus LMWH (n = 40); heparin plus LMWH (n = 43) | 55 | 39.7 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) or myocardial injury (BNP) without systolic hypotension | Tenecteplase 30-50 mg (bolus) | Systemic |
| Kostantinides et al21 | Thrombolytic plus UFH (n = 118); placebo plus UFH (n = 138) | 62 | 52.3 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 100 mg (bolus + 2-h infusion) | Systemic |
| Kucher et al22 | Thrombolytic plus UFH (n = 30); UFH alone (n = 29) | 63 | 49.1 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 10-20 mg (15-h infusion) | Directed (ultrasound assisted) |
| Levine et al23 | Thrombolytic plus UFH (n = 33); placebo plus UFH (n = 25) | 61 | 50.0 | Acute PE (any) without systolic hypotension | rt-PA 0.6 mg/kg ideal body weight (bolus) | Systematic |
| Liu et al24 | Thrombolytic plus LMWH (n = 30); LMWH alone (n = 24) | 58.2 | No significant differences between sexes | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 50 mg (bolus) | Systemic |
| Lu et al25 | Thrombolytic plus LMWH (n = 51); LMWH alone (n = 55) | 60.8 | 25.5 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Urokinase 20 000 IU/kg (bolus) | Systemic |
| Ly et al26 | Thrombolytic plus UFH (n = 14); UFH alone (n = 10) | 53.2 | 56 | Acute PE (any) without systolic hypotension. | Streptokinase 7 450 000 IU (bolus + 72-h infusion) | Systemic |
| Meyer et al27 | Thrombolytic plus UFH (n = 506); placebo plus UFH (n = 499) | 66.2 | 52.9 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography or CT) plus myocardial injury (troponin) without systolic hypotension | Tenecteplase 30-50 mg (bolus) | Systemic |
| PIOPED28 | Thrombolytic plus UFH (n = 9); placebo plus heparin (n = 4) | 58.5 | 30.8 | Acute PE (any) without systolic hypotension. | rt-PA 40-80 mg (40- to 90-min infusion) | Systemic |
| Sharifi et al29 | Thrombolytic plus UFH (n = 61); UFH alone (n = 60) | 58.5 | 54.5 | Acute submassive- or intermediate-risk PE clinically defined (chest pain, tachypnea, tachycardia, dyspnea, cough oxygen desaturation or elevated venous pressure) or RVD (echocardiography) or myocardial injury (troponin or BNP) without systolic hypotension | rt-PA 50 mg (bolus + 2-h infusion) | Systemic |
| Sun30 | Thrombolytic plus LMWH (n = 46); LMWH alone (n = 46) | 56.3 | 44.6 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Urokinase 500 000 IU (bolus) | Systemic |
| Taherkhani et al31 | Thrombolytic plus UFH (n = 25); UFH alone (n = 25) | 55.7 | 60 | Acute submassive- or intermediate-risk PE defined as RVD or enlargement (echocardiography) without systolic hypotension | rt-PA 100 mg (90-min infusion) or streptokinase 1 500 000 (2-h infusion) | Systemic |
| Tibutt et al32 | Thrombolytic (n = 13); UFH (n = 17) | 48.7 | 50 | Acute PE (any); mean systolic BP 108 mmHg | Streptokinase 600 000 IU (bolus + 72-h infusion) | Infused in the pulmonary artery |
| UKEP33 | Thrombolytic (n = 82); UFH (n = 78) | 49.4% >50 y* | 42.5 | Acute PE (any); 8.7% with hemodynamic compromise | Urokinase 2 000 (12-h infusion); 4 400 IU/kg (24-h infusion) | Infused in the pulmonary artery |
| Wei and Sun34 | Thrombolytic (n = 28); LMWH (n = 28); 2 lost to follow-up in the control group | 58 | 40.0 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 50 mg (bolus) | Systemic |
| Zhang et al35 | Thrombolytic (n = 26); LMWH (n = 29) | 68 | 41.8 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | rt-PA 50 mg (bolus) | Systemic |
| Ou36 | Thrombolytic (n = 54); UFH (n = 54) | 58.3 | 28.7 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) without systolic hypotension | Urokinase 20 000 IU/kg (bolus) | Systemic |
| Marini et al37 | Thrombolytic (n = 20); UFH (n = 10) | 53 | 40.0 | Acute PE (any) without systolic hypotension. | Urokinase 2 400 000 IU (36-h infusion) | Systemic |
| Ahmed et al38 | Thrombolytic (n = 24); UFH (n = 28) | 44.7 | 53.8 | Acute submassive- or intermediate-risk PE defined as RVD (echocardiography) or myocardial injury (troponin or BNP) without systolic hypotension | Streptokinase 1 500 000 IU (2-h infusion) | Systemic |
| Zhang et al39 | Thrombolytic (n = 33); LMWH (n = 33) | 59.5 | 51.5 | Acute intermediate-risk PE defined as RVD (echocardiography) or myocardial injury (troponin or BNP) without systolic hypotension | rt-PA 30 mg (2-h infusion) | Systemic |
BNP, beta-natriuretic peptide; BP, blood pressure; CT, computed tomography; LMWH, low molecular weight heparin; RV, right ventricle; RVD, right ventricular dysfunction; UFH, unfractionated heparin; VQ, ventilation/perfusion.
Study did not report mean age.