PEITHO
Pulmonary Embolism Thrombolysis trial
Patient / Population Intervention / Exposure Comparison Outcome
In 1,006 patients with intermediate-risk pulmonary embolism, tenecteplase reduced haemodynamic decompensation but increased major and intracranial bleeding compared with heparin alone.
N
1,006
Design
Double-blind RCT
Endpoint
Death or haemodynamic decompensation at 7 days
Relevance
1
Result2.6 % vs 5.6 % (OR 0.44); intracranial haemorrhage 2.0 % vs 0.2 %.
Meyer G, et al. N Engl J Med. 2014;370(15):1402-1411. 10.1056/NEJMoa1302097
Discussion & critique
Net harm from routine full-dose fibrinolysis in intermediate-risk PE — class III. Drove interest in reduced-dose lysis and catheter-directed therapy.