Evidence map›Paper›PMID 38410989›Full record

Observational studyCirculation. Cardiovascular interventions2024

Clinical Outcomes and Predictors of Advanced Therapy for the Management of Right Heart Thrombus.

Nathan W Watson, Ido Weinberg, Andrew B Dicks, Brett J Carroll, Eric A Secemsky

Abstract readObservational Study
In one paragraph

Observational study in Circulation. Cardiovascular interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nathan W WatsonHarvard Medical School, Boston, MA (N.W.W., I.W., B.J.C., E.A.S.).ORCID 0000-0001-5322-8058
Ido WeinbergHarvard Medical School, Boston, MA (N.W.W., I.W., B.J.C., E.A.S.).ORCID 0000-0003-4633-5132
Andrew B DicksDepartment of Vascular Surgery, Prisma Health/University of South Carolina School of Medicine - Greenville (A.B.D.).
Brett J CarrollHarvard Medical School, Boston, MA (N.W.W., I.W., B.J.C., E.A.S.).ORCID 0000-0002-6704-5663
Eric A SecemskyHarvard Medical School, Boston, MA (N.W.W., I.W., B.J.C., E.A.S.).ORCID 0000-0003-3861-3163

Funding

Shared Decision-Making to Improve the Health Status of Patients with Claudication: Developing and Implementing Strategies to Individualize Treatment DecisionsK23HL150290 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SECEMSKY, ERIC ALEXANDER · 2020 to 2024
$851k
NHLBI NIH HHS K23 HL150290
6 · The paper itself

Abstract

backgroundThe role of advanced therapies (systemic thrombolysis, catheter-based treatment, and surgical thrombectomy) for the management of right heart thrombus is poorly defined. In this study, we assessed the clinical predictors and outcomes of advanced therapy compared with anticoagulation alone for the acute management of right heart thrombus.

methodsIn this observational cohort study, we analyzed consecutive patients who were treated for right heart thrombus. The primary end point was 90-day all-cause mortality. Clinical predictors of utilizing advanced therapy were assessed with multivariable logistic regression. Propensity score matching was utilized to compare adjusted outcomes between patients receiving advanced therapies versus anticoagulation alone.

resultsA total of 345 patients were included in the study. Advanced therapy was utilized in 13.6% (N=47) of patients, of which 25.5% (N=12/47) was systemic thrombolysis, 23.4% (N=11/47) was endovascular thrombectomy, and 53.2% (N=25/47) was surgical thrombectomy. Younger age (odds ratio, 0.98 [95% CI, 0.96-0.99]) and concurrent pulmonary embolism (odds ratio, 5.36 [95% CI, 2.48-12.1]) predicted utilization of advanced therapy. In propensity score-matched analysis, there was no difference in 90-day mortality (hazard ratio, 0.46 [95% CI, 0.17-1.22]), in-hospital mortality (odds ratio, 0.64 [95% CI, 0.17-2.19]), or length of stay (β, -4.39 [95% CI, -14.0 to 5.22]) between advanced therapy and anticoagulation.

conclusionsAmong a diverse cohort of patients with right heart thrombus, outcomes did not differ between those who underwent advanced therapy and anticoagulation alone. Important predictors for utilizing advanced treatment included younger age and the presence of a concurrent pulmonary embolism. Future studies assessing advanced therapy in larger and broader patient populations are necessary.

Indexed as

Pulmonary EmbolismThrombosisAnticoagulantsHumansThrombectomyThrombolytic TherapyTreatment OutcomeAnticoagulantsanticoagulationembolectomypulmonary embolismthrombectomythrombolysisvenous thromboembolism

Identifiers

PMID38410989
PMCPMC11021139

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.