Urokinase Pulmonary Embolism Trial

Abstract

In a randomized, national cooperative trial, urokinase and subsequent heparin sodium therapy, when compared to heparin therapy alone, significantly accelerated the resolution rate of pulmonary thromboemboli at 24 hours as shown by pulmonary arteriograms, lung scans, and right-sided pressure measurements. No significant differences in recurrence rate of pulmonary embolism or in the two-week mortality were observed. Bleeding, which occurred in 45% of patients receiving urokinase as contrasted to 27% in the heparin group, was the only complication of urokinase therapy. This increase in bleeding seen with urokinase was closely associated with the invasive procedures necessary to obtain the arteriographic and hemodynamic information. Because the urokinase regimen did not usually achieve complete or nearly complete thrombolysis, and because of its hemorrhagic property, further studies with urokinase in pulmonary thromboembolism are indicated before specific therapeutic recommendations can be made.