Jing X, et al. - In this study, the incidence of pulmonary thromboembolism (PTE) was investigated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the efficacy and safety of low-dose urokinase (UK) thrombolysis therapy was assessed for the treatment of hemodynamically stable AECOPD patients with acute PTE (AECOPD-PTE). As per findings, the incidence of PTE in AECOPD patients was 22.9%, especially with a higher occurrence rate in severe COPD. Relative to anticoagulation-only therapy, a better efficacy and safety could be obtained with low-dose UK treatment (500000IU/d for 5-7 days) in hemodynamically stable AECOPD patients with acute PTE, corresponding with a higher effective rate (97.2%) and lower adverse events rate (8.3%) respectively.

Methods

• In this study, researchers enrolled a total of 419 AECOPD patients, including 96 AECOPD-PTE; 30 AECOPD-PTE patients were collected retrospectively and 66 AECOPD-PTE patients were prospectively categorized into anticoagulation-only, low-dose UK and standard-dose UK groups.
• Follow-up 1 year, they assessed the efficacy and safety of low-dose UK therapy for hemodynamically stable AECOPD-PTE patients.

Results

• Findings demonstrated that the incidence of PTE in AECOPD patients was 22.9% (96/419), which increased with COPD severity degree ranging from 3.5% (2/57) in mild, 13.6% (19/140) in moderate and 33.8% (75/222) in severe subgroups (P<0.05).
• Data from the prospective study revealed that the total effective rate of low-dose UK group 97.2% (35/36) was higher than that in anticoagulation 75.0% (12/16) and standard-dose UK group 78.6% (11/14) respectively (P<0.05).
• Researchers observed that in the follow-up, the adverse events rate in low-dose UK group 8.3% (3/36) vs in anticoagulation group 25.0% (4/16) and standard-dose UK group 71.4% (10/14), respectively (P<0.05), was significantly lower.
• A longer mean PTE recurrence time of low-dose UK group (9.0±0) months was reported, compared with anticoagulation group (2.0±1.41) months (P<0.05).
• In addition, data revealed that AECOPD relapse time in anticoagulation, low-dose UK and standard-dose UK groups corresponding to (8.5±2.12), (9.0±0) and (8.8±3.40) months were compared with no significant difference (P>0.05).