Treating Patients Who Have Intermediate-Risk Acute Pulmonary Embolus

Although management of patients with acute pulmonary embolus is well defined for those at high risk (intensive care and reperfusion therapy) and low risk (outpatient anticoagulation), how to treat patients with acute intermediate-risk pulmonary embolus — defined by the presence of right ventricular (RV) dysfunction, with or without elevated cardiac troponin level — is less clear.

Researchers performed a trial in 402 adult patients with symptomatic intermediate-risk pulmonary embolism at 42 hospitals in Europe. Patients received parenteral low-molecular-weight or unfractionated heparin for 72 hours after diagnoses of pulmonary embolism before switching to oral dabigatran (150 mg twice daily) after standard assessment of clinical stability (95…