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Connect Usb Device To Serial Computer Cables more. Methods In a randomized, double-blind trial, we compared tenecteplase plus heparin with placebo plus heparin in normotensive patients with intermediate-risk pulmonary embolism. Eligible patients had right ventricular dysfunction on echocardiography or computed tomography, as well as myocardial injury as indicated by a positive test for cardiac troponin I or troponin T. The primary outcome was death or hemodynamic decompensation (or collapse) within 7 days after randomization. The main safety outcomes were major extracranial bleeding and ischemic or hemorrhagic stroke within 7 days after randomization. Results Of 1006 patients who underwent randomization, 1005 were included in the intention-to-treat analysis. Death or hemodynamic decompensation occurred in 13 of 506 patients (2.6%) in the tenecteplase group as compared with 28 of 499 (5.6%) in the placebo group (odds ratio, 0.44; 95% confidence interval, 0.23 to 0.87; P=0.02).

Between randomization and day 7, a total of 6 patients (1.2%) in the tenecteplase group and 9 (1.8%) in the placebo group died (P=0.42). Extracranial bleeding occurred in 32 patients (6.3%) in the tenecteplase group and 6 patients (1.2%) in the placebo group (P. Acute pulmonary embolism occurs frequently and may cause death or serious disability. Case fatality rates vary widely, but approximately 10% of all patients with acute pulmonary embolism die within 3 months after the diagnosis. Acute right ventricular pressure overload at diagnosis is an important determinant of the severity and early clinical outcome of pulmonary embolism.

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Epcs Serial Flash Controller Qsys there. High-risk pulmonary embolism is characterized by overt hemodynamic instability and warrants immediate advanced therapy, including consideration of fibrinolysis. In contrast, for patients presenting without systemic hypotension or hemodynamic compromise, standard anticoagulation is generally considered adequate treatment. However, patients who have acute right ventricular dysfunction and myocardial injury without overt hemodynamic compromise may be at intermediate risk for an adverse early outcome.

These patients (referred to henceforth as patients with intermediate-risk pulmonary embolism) may also be candidates for early reperfusion therapy. Randomized clinical trials that test fibrinolytic agents versus heparin alone in patients with acute pulmonary embolism have enrolled, in total, fewer than 1000 patients over the past 40 years. Although these drugs have been shown to rapidly improve hemodynamic variables, their effects on the clinical outcome, particularly in patients without hemodynamic instability at presentation, have not been determined. The Pulmonary Embolism Thrombolysis (PEITHO) trial was designed to investigate the clinical efficacy and safety of fibrinolytic therapy with a single-bolus injection of tenecteplase, in addition to standard anticoagulation therapy with heparin, in normotensive patients with acute pulmonary embolism and an intermediate risk of an adverse outcome.