On this episode, Pip and Rich discuss HI-PEITHO, a randomised controlled trial of catheter-directed fibrinolysis in patients presenting with intermediate risk PE. This was an industry-sponsored trial. Patients could be included if they had a ratio of RV:LV end diastolic diameter of ≥1.0 and an elevated troponin level + at least two of SBP ≤110 mm Hg, HR ≥100 bpm, or a respiratory rate of >20 breaths per minute.
The primary outcome was a composite of pulmonary embolism–related death, cardiorespiratory decompensation or collapse or symptomatic recurrence of pulmonary embolism within 7 days.
After randomising 544 patients, a primary-outcome event occurred in 11 patients in the intervention group and 28 in the usual care arm (relative risk, 0.39; 95% CI, 0.20 to 0.77; P=0.005). So, is this a slam dunk? Should we roll out this intervention? Here we discuss the nuances of the primary outcome finding that it was mostly driven by number of patients who had a NEWS score of 9 or more, 24 hours after randomisation. Pip and Rich debate the meaning of this outcome and much more. This is most definitely a study where reading beyond the abstract is 100% necessary!
Novo Nordisk has provided sponsorship to HaemSTAR to cover the costs of the development of Don’t Just Read the Abstract initiative. Novo Nordisk has had no influence over the creation, development, or content of any of the materials available
","author_name":"Richard Buka"}