Meta-analysis of efficacy and safety of thrombolysis and anticoagulation in initial treatment of medium-risk acute pulmonary embolism

Objective To compare the efficacy and safety of thrombolysis and anticoagulation in the initial treatment of medium-risk acute pulmonary embolism. Methods Computer-based retrieval was performed on PubMed, Medline, CNKI, Wanfang and VIP database.Randomized controlled trials of thrombolysis and anticoagulation in the initial treatment of medium-risk acute pulmonary embolism were collected.Revman 5.3 software was used to perform meta-analysis. Results Fifteen randomized controlled trials were included in this paper.In terms of efficacy, the recurrence rate of medium-risk acute pulmonary embolism in anticoagulation group was higher than that in thrombolysis group (OR=0.46, 95% CI: 0.27~0.77, P=0.003). There was no significant difference in the mortality between thrombolysis and anticoagulation.In terms of security, the main and secondary bleeding rates of medium-risk acute pulmonary embolism in anticoagulation group were lower than those in thrombolysis group. Conclusions Thrombolytic therapy can reduce the recurrence rate of patients with medium-risk acute pulmonary embolism, and thrombolytic therapy is associated with increase of bleeding rate. Key words: Acute pulmonary embolism; Medium-risk; Thrombolysis; Anticoagulants; Meta-analysis