EFFICACY OF TISSUE PLASMINOGEN ACTIVATOR, HEPARIN AND STREPTOKINASE IN PATIENTS WITH SUB MASSIVE PULMONARY EMBOLISM IN A TERTIARY CARE CARDIAC HOSPITAL: A CASE SERIES

Abstract

Objective: To determine the clinical characteristics and outcomes of 57 cases of Pulmonary embolism in relation to use of thrombolytics and anticoagulants.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Adult cardiology department of AFIC & NIHD from Oct 2017 till Dec 2018.

Material and Methods: Fifty seven patients with pulmonary embolism were included in the study using consecutive sampling technique. Clinical characteristics and outcomes of the patients were noted and analyzed. SPSS-23 was used for data analysis.

Results: Fifty Seven cases of acute pulmonary embolism were included in our study and were admitted to the coronary care unit of hospital during the study period. Mean age of patients was 43.6 ± 17.88 years with minimum age 20 years and maximum 83 years. There were 47 (82.5%) male patients while 10 (17.50%) female patients. Most common NYHA class with which patients presented was, class III 27 (47.5%) followed by class IV 15 (26.3%), class II 9 (15.7) and class I 6 (10.5). The most common CT Pulmonary Angiogram finding of the patients was bilateral segmental embolism 30 (52.6%) followed by bilateral massive in 17 (29.8). Out of 57 patients, 22 (38.60%) patients received streptokinase and ten (17.5%) received tissue plasminogen activator (TPA). Nine patients were found to have deep venous thrombosis. Mortality was 12.30% (n=7).

Conclusion: Acute pulmonary embolism is a relatively common medical emergency and accurate diagnosis in early period can help institute appropriate thrombolytic therapy to maximally benefit the patients.