Pros, Cons to Dissolving Lung Clots: Study
Clot-busting drugs appear to save lives but increase risk of serious bleeding
"The rate of death has decreased significantly over the more than four decades of studies included, making it harder to show a benefit of clot-busting therapy in the most recent studies," Beckman said.
He'd like to see how clot-busters compare to newer blood thinners, he said. Also, it's still not clear if the drugs should be delivered intravenously or by catheter directly to the lungs, he noted.
Whether only younger patients should receive thrombolytics is another question for future study, Beckman said.
For the current study, Giri's team analyzed data from studies published over 45 years that included 2,115 patients in all.
The investigators found that clot-dissolving drugs reduced the relative risk of dying early by 47 percent. Among those given these drugs, 2.2 percent died, compared with 3.9 percent of those not receiving clot-busting therapy.
But the risk of major bleeding was nearly tripled with clot-busting drugs compared with drugs used to prevent clotting -- 9.2 percent versus 3.4 percent, the researchers found. Major bleeding was not significantly increased in patients 65 and younger, the authors noted.
Those receiving the clot-busting therapy were also more likely to suffer brain bleeding than those given anti-clotting drugs (1.5 percent versus 0.2 percent). But they were less likely to have another clot in the lung (1.2 percent versus 3 percent), the study found.
Each year pulmonary embolism contributes to almost 30,000 U.S. deaths. Risk of death is heightened for up to three months after the clot occurs, the researchers said.