Current approaches to diagnosis, treatment and prevention of pulmonary embolism

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Abstract

Pulmonary embolism (PE) is one of the most common diseases, comparable in frequency with acute coronary syndrome, and is one of the leading causes of cardiovascular mortality. The high mortality associated with pulmonary embolism (PE) is determined by the severity of the disease and the difficulties of diagnosis and in large part by a lack of awareness of doctors on standards for primary prevention.The last decade has been marked by qualitative improvement in the efficiency of diagnosis of pulmonary embolism, which resulted from the achievements in echocardiography and increased availability of computer tomography imaging in real practice. The list of availbale anticoagulant drugs which are the basis of pathogenetic treatment, secondary and primary prevention of pulmonary embolism expanded significantly. The present review covers the principles of diagnosis, therapy and prevention of this disease.

About the authors

L. L Bershteyn

I.I.Metchnikov North western State Medical University, St. Petersburg

Email: L_berstein@yahoo.com
д-р мед. наук, проф. каф. кардиологии им. М.С.Кушаковского

References

  1. Torbicki A, Perrier A, Konstantinides S et al. Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology. Eur Heart J 2008; 29: 2276-315.
  2. Anderson J, Adams C, Antman E et al. ACC/AHA 2007 Guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 2002 Guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction). J Am Coll Cardiol 2007; 50 (7): e1-e157.
  3. Савельев В.С., Чазов Е.И., Гусев Е.И. и др. Ассоциация флебологов России. Всероссийское общество хирургов. Национальное общество по атеротромбозу. Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. М.: Планида, 2012.
  4. Kearon C, Akl E.A, Comerota A.J et al. Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence - based clinical practice guidelines. Chest 2012; 141: e419S-e494S.
  5. Бунин Ю.А. Диагностика и лечение тромбоэмболии легочной артерии: современное состояние проблемы. Трудный пациент. 2005; 4.
  6. Scarvelis D, Wells P.S. Diagnosis and treatment of deep - vein thrombosis. CMAJ 2006; 175 (9): 1087-92.
  7. Di Nisio M, Squizzato A, Rutjes A.W et al. Diagnostic accuracy of D-dimer test for exclusion of venous thromboembolism: a systematic review. J Thromb Haemost 2007; 5: 296-304.
  8. Haas F.J, Schutgens R.E, Biesma D.H. An age - adapted approach for the use of D-dimers in the exclusion of deep venous thrombosis. Am J Hematol 2009; 84 (8): 488-91.
  9. Schouten H.J, Koek H.L, Oudega R et al. Validation of two age dependent D-dimer cut - off values for exclusion of deep vein thrombosis in suspected elderly patients in primary care: retrospective, cross sectional, diagnostic analysis. BMJ 2012; 344: e2985.
  10. Wood K.E. Major pulmonary embolism. Review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest 2002; 121: 877-905.
  11. Sanchez O, Trinquart L, Colombet I et al. Prognostic value of right ventricular dysfunction in patients with haemodynamically stable pulmonary embolism: a systematic review. Eur Heart J 2008; 29: 1569-77.
  12. Mikulewicz M, Lewczuk J. Importance of cardiac biomarkers in risk stratification in acute pulmonary embolism. Cardiol J 2008; 15 (1): 17-20.
  13. Korff S, Katus H.A, Giannitsis E. Differential diagnosis of elevated troponins. Heart 2006; 92: 987-93.
  14. Montoya R.C, Gajra A. Current status of new anticoagulants in the management of venous thromboembolism. Adv Hematol 2012; 2012: 856341.
  15. Steffel J, Braunwald E. Novel oral anticoagulants: focus on stroke prevention and treatment of venous thrombo - embolism. Eur Heart J 2011; 32: 1968-76.
  16. The EINSTEIN-PE Investigators. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med 2012; 366: 1287.
  17. Рабочая группа Европейского общества кардиологов. Рекомендации Европейского общества кардиологов по диагностике и лечению фибрилляции предсердий. Рацион. фармакотерапия в кардиологии. 2011; (Прил.) 1-2: 3-66.
  18. Cohen A.T, Tapson V.F, Bergmann J.F et al. ENDORSE Investigators. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross - sectional study. Lancet 2008; 371 (9610): 387-94.
  19. Spyropoulos A.C. Emerging strategies in the prevention of venous thromboembolism in hospitalized medical patients. Chest 2005; 128: 958-69.
  20. Selby R, Geerts W. Prevention of venous thromboembolism: consensus, controversies, and challenges. Hematology Am Soc Hematol Educ Program 2009; с. 286-92.
  21. Falck-Ytter Y, Francis C.W, Johanson N.A et al. Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians. Evidence - based clinical practice guidelines. Prevention of VTE in orthopedic surgery patients. Chest 2012; (Suppl.) 141 (2): e278S-e325S.

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