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[Anticoagulant therapy in pulmonary embolism]
B Charbonnier1, G Pacouret, M P Augusseau-Richard
1Service de cardiologie D et Unité de soins cardiaques intensifs, CHU Trousseau, Tours.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|November 1, 1995
Summary
Pulmonary embolism treatment primarily uses anticoagulant therapy, significantly reducing mortality. Current effective treatments include heparin and vitamin K antagonists, with new options like low molecular weight heparin emerging.
Area of Science:
- Cardiology
- Hematology
- Vascular Medicine
Background:
- Thromboembolic disease encompasses venous thrombosis and pulmonary embolism.
- Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
- Anticoagulant therapy has been the cornerstone of PE treatment for decades.
Purpose of the Study:
- To review the established and emerging treatments for pulmonary embolism.
- To highlight the efficacy and safety of current anticoagulant therapies.
- To discuss the potential future directions in PE management.
Main Methods:
- Review of established anticoagulant treatment protocols for pulmonary embolism.
- Analysis of efficacy and safety data for current therapies.
- Discussion of emerging anticoagulant agents and their potential applications.
Main Results:
- Anticoagulant therapy reduces PE mortality from 25% to 6%.
- Conventional treatment involves intravenous heparin followed by oral vitamin K antagonists (International Normalized Ratio 2-3).
- Recurrence rates are low (approx. 5%) with severe bleeding complications at 3-5%.
Conclusions:
- Heparin and vitamin K antagonists remain the safest and most effective treatments for pulmonary embolism.
- Low molecular weight heparin shows promise for mild to moderate PE.
- Hirudine and heparinoids represent potential future therapeutic options.