Patients with blood clots in lungs often go sans most effective therapies

According to a recent study, pulmonary embolism (PE) treatments have low rates of use across the United States.

PE, a blood clot in the lungs that causes shortness of breath and chest pain, is the third leading cardiovascular cause of death in the United States with more than 100, 000 lives taken each year.

A typical intervention for PE patients includes anticoagulants in an effort to prevent migration of the blood clot, but the higher-risk PE population (about 30 percent of all PE patients) are potential candidates for catheter-directed thrombolysis (CDT) and systemic thrombolysis (ST), both of which employ "clot-busting" medications known as tissue plasminogen activator (tPA).

However, in a new study, the University of Pennsylvania researchers found that the utilization rates of these potentially life-saving medications are low, particularly in the sub-group of PE patients who are critically ill.

ST is the method in which "clot-busting" medication is administered intravenously (IV) to eliminate clots throughout the bloodstream, while CDT allows the medication to be directly administered into the clot in the lungs.

"For years, ST and CDT have been available for use in patients with PE, however, there has been little research done to understand how these therapies are being utilized in the real-world," said the study's presenter Srinath Adusumalli.

He added, "Our initial data suggest that, in fact, both ST and CDT are used infrequently to treat PE, including in young, critically ill patients who may experience the highest clinical benefit from those therapies."

"Another question that emerged from these findings is whether we are adequately matching the right patients to the right therapies at the right time," said senior author Peter W. Groeneveld. "Since there is a lack of real-world clinical effectiveness and safety data on these therapies and a resulting lack of guideline-based recommendations, substantial clinical uncertainty persists as to when and in whom to use CDT and ST."

While the team notes these data are clinically useful and could impact the patient care decision-making process, there is still more research needed.

The study was presented at American College of Cardiology's 66th Annual Scientific Session.