MOPETT
Trial question
What is the role of low-dose thrombolysis in patients with moderate PE?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
55.0% female
45.0% male
N = 121
121 patients (66 female, 55 male).
Inclusion criteria: patients with moderate PE.
Key exclusion criteria: eligibility for full-dose thrombolysi,contraindication to unfractionated or low-molecular-weight heparin, severe thrombocytopenia, major bleeding within < 2 months requiring transfusion, surgery or major trauma within < 2 weeks, brain mass.
Interventions
N=61 thrombolysis ("safe dose" of tPA plus anticoagulation).
N=60 control (anticoagulation alone).
Primary outcome
Pulmonary hypertension at 28 months
16%
57%
57.0 %
42.8 %
28.5 %
14.3 %
0.0 %
Thrombolysis
Control
Significant
decrease ▼
NNT = 2
Significant decrease in pulmonary hypertension at 28 months (16% vs. 57%; RR 0.28, 95% CI 0.11 to 0.45).
Secondary outcomes
Significant decrease in pulmonary hypertension or recurrent PE (16% vs. 63%; RR 0.25, 95% CI 0.1 to 0.4).
Significant decrease in death or recurrent PE (1.6% vs. 10%; RR 0.16, 95% CI 0 to 0.32).
Significant decrease in duration of hospitalization (2.2 vs. 4.9; AD -2.7 , 95% CI -4.3 to -1.1).
Conclusion
In patients with moderate PE, thrombolysis was superior to control with respect to pulmonary hypertension at 28 months.
Reference
Sharifi M, Bay C, Skrocki L et al. Moderate pulmonary embolism treated with thrombolysis (from the "MOPETT" Trial). Am J Cardiol. 2013 Jan 15;111(2):273-7.
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