Author + information
- Received October 14, 2015
- Revision received November 11, 2015
- Accepted November 17, 2015
- Published online March 1, 2016.
- Stavros V. Konstantinides, MD, PhDa,b,∗ (, )
- Stefano Barco, MDa,
- Mareike Lankeit, MDa and
- Guy Meyer, MDc
- aCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- bDepartment of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
- cHôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, and GIRC Thrombose, Paris, France
- ↵∗Reprint requests and correspondence:
Prof. Stavros V. Konstantinides, Center for Thrombosis and Hemostasis, University Medical Center Mainz, Langenbeckstrasse 1, Building 403, 55131 Mainz, Germany.
Pulmonary embolism (PE) remains a major contributor to global disease burden. Risk-adapted treatment and follow-up contributes to a favorable outcome. Age-adjusted cutoff levels increase D-dimer specificity and may decrease overuse of imaging procedures and overdiagnosis of PE. Primary systemic fibrinolysis has an unfavorable risk–benefit ratio in intermediate-risk PE; catheter-directed techniques are an option for patients with hemodynamic decompensation and high bleeding risk. New oral anticoagulant agents are effective and safe alternatives to standard anticoagulation regimens. Recent trial data do not support insertion of cava filters in patients who can receive anticoagulant treatments. Remaining areas of uncertainty include the therapeutic implications of subsegmental PE, the optimal diagnostic approach to the pregnant patient with suspected PE, and the efficacy and safety of new oral anticoagulant agents in patients with cancer. Campaigns to increase awareness combined with strategies to implement guideline recommendations will be crucial steps towards further optimizing management of acute PE.
The work of Drs. Konstantinides, Barco, and Lankeit was supported by the German Federal Ministry of Education and Research (BMBF 01EO1003 and 01EO1503). The authors are responsible for the contents of this paper. Dr. Konstantinides has received consultancy and lecture honoraria from Bayer HealthCare, Boehringer Ingelheim, Daiichi-Sankyo, and Pfizer–Bristol-Myers Squibb; payment for travel accommodation/meeting expenses from Bayer HealthCare; and institutional grants from Boehringer Ingelheim, Bayer HealthCare, and Daiichi-Sankyo. Dr. Barco has received an educational travel grant from Daiichi-Sankyo. Dr. Lankeit has received consultancy and lecture honoraria from Actelion, Bayer HealthCare, Daiichi-Sankyo, and Pfizer–Bristol-Myers Squibb. Dr. Meyer has received payment for travel accommodation/meeting expenses from Bayer HealthCare, Leo Pharma, and Daiichi-Sankyo; board membership, consultancy, and lecture honoraria to his institution from Bayer HealthCare, Pfizer–Bristol-Myers Squibb, Sanofi, Leo Pharma, and Daiichi-Sankyo; and institutional grants from Boehringer Ingelheim, and Leo Pharma.
- Received October 14, 2015.
- Revision received November 11, 2015.
- Accepted November 17, 2015.
- American College of Cardiology Foundation
- Evolving Strategies for Diagnosis and Risk Assessment
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- Current Controversies and Areas of Ongoing Research