Contribution of fibrinolysis to the physical component summary of the SF-36 after acute submassive pulmonary embolism

Lauren K. Stewart; Geoffrey W. Peitz; Kristen E. Nordenholz; D. Mark Courtney; Christopher Kabrhel; Alan E. Jones; Matthew T. Rondina; Deborah B. Diercks; James R. Klinger; Jeffrey A. Kline

doi:10.1007/s11239-014-1155-5

Contribution of fibrinolysis to the physical component summary of the SF-36 after acute submassive pulmonary embolism

Lauren K. Stewart, Geoffrey W. Peitz, Kristen E. Nordenholz, D. Mark Courtney, Christopher Kabrhel, Alan E. Jones, Matthew T. Rondina, Deborah B. Diercks, James R. Klinger, Jeffrey A. Kline^*

^*Corresponding author for this work

Emergency Medicine

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Acute pulmonary embolism (PE) can diminish patient quality of life (QoL). The objective was to test whether treatment with tenecteplase has an independent effect on a measurement that reflects QoL in patients with submassive PE. This was a secondary analysis of an 8-center, prospective randomized controlled trial, utilizing multivariate regression to control for predefined predictors of worsened QoL including: age, active malignancy, history of PE or deep venous thrombosis (DVT), recurrent PE or DVT, chronic obstructive pulmonary disease and heart failure. QoL was measured with the physical component summary (PCS) of the SF-36. Analysis included 76 patients (37 randomized to tenecteplase, 39 to placebo). Multivariate regression yielded an equation f(8, 67), P < 0.001, with R² = 0.303. Obesity had the largest effect on PCS (β = −8.6, P < 0.001), with tenecteplase second (β = 4.73, P = 0.056). After controlling for all interactions, tenecteplase increased the PCS by +5.37 points (P = 0.027). In patients without any of the defined comorbidities, the coefficient on the tenecteplase variable was not significant (−0.835, P = 0.777). In patients with submassive PE, obesity had the greatest influence on QoL, followed by use of fibrinolysis. Fibrinolysis had a marginal independent effect on patient QoL after controlling for comorbidities, but was not significant in patients without comorbid conditions.

Original language	English (US)
Pages (from-to)	161-166
Number of pages	6
Journal	Journal of thrombosis and thrombolysis
Volume	40
Issue number	2
DOIs	https://doi.org/10.1007/s11239-014-1155-5
State	Published - Nov 30 2015

Funding

JAK owns stock in CP Diagnostics LLC is a consultant for Daiichi Sankyo Inc, Donawa Lifesciences Consulting, Janssen, and Stago Diagnostica, and has received funding from the Agency for Healthcare Reform, National Institutes for Health. Study funded by an investigator initiated Grant from Genentech, Inc. (Grant #: N3944). AEJ has received funding from the National Institutes of Health. DBD serves as a consultant for Daiichi Sankyo, Beckmann Coulter, Mylan and has received research support from Radiometer, Alere, DOD and the National Institutes of Health. CK is a consultant for Diagnostica Stago, Siemens Healthcare and has received grant funding to his institution from Diagnostica Stago, Siemens Healthcare, the Harvard Milton Fund and the National Institutes of Health.

Keywords

Fibrinolysis
Pulmonary embolism
Quality of life
Submassive

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Hematology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s11239-014-1155-5

Cite this

Stewart, L. K., Peitz, G. W., Nordenholz, K. E., Courtney, D. M., Kabrhel, C., Jones, A. E., Rondina, M. T., Diercks, D. B., Klinger, J. R., & Kline, J. A. (2015). Contribution of fibrinolysis to the physical component summary of the SF-36 after acute submassive pulmonary embolism. Journal of thrombosis and thrombolysis, 40(2), 161-166. https://doi.org/10.1007/s11239-014-1155-5

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abstract = "Acute pulmonary embolism (PE) can diminish patient quality of life (QoL). The objective was to test whether treatment with tenecteplase has an independent effect on a measurement that reflects QoL in patients with submassive PE. This was a secondary analysis of an 8-center, prospective randomized controlled trial, utilizing multivariate regression to control for predefined predictors of worsened QoL including: age, active malignancy, history of PE or deep venous thrombosis (DVT), recurrent PE or DVT, chronic obstructive pulmonary disease and heart failure. QoL was measured with the physical component summary (PCS) of the SF-36. Analysis included 76 patients (37 randomized to tenecteplase, 39 to placebo). Multivariate regression yielded an equation f(8, 67), P < 0.001, with R2 = 0.303. Obesity had the largest effect on PCS (β = −8.6, P < 0.001), with tenecteplase second (β = 4.73, P = 0.056). After controlling for all interactions, tenecteplase increased the PCS by +5.37 points (P = 0.027). In patients without any of the defined comorbidities, the coefficient on the tenecteplase variable was not significant (−0.835, P = 0.777). In patients with submassive PE, obesity had the greatest influence on QoL, followed by use of fibrinolysis. Fibrinolysis had a marginal independent effect on patient QoL after controlling for comorbidities, but was not significant in patients without comorbid conditions.",

keywords = "Fibrinolysis, Pulmonary embolism, Quality of life, Submassive",

author = "Stewart, {Lauren K.} and Peitz, {Geoffrey W.} and Nordenholz, {Kristen E.} and Courtney, {D. Mark} and Christopher Kabrhel and Jones, {Alan E.} and Rondina, {Matthew T.} and Diercks, {Deborah B.} and Klinger, {James R.} and Kline, {Jeffrey A.}",

note = "Funding Information: JAK owns stock in CP Diagnostics LLC is a consultant for Daiichi Sankyo Inc, Donawa Lifesciences Consulting, Janssen, and Stago Diagnostica, and has received funding from the Agency for Healthcare Reform, National Institutes for Health. Study funded by an investigator initiated Grant from Genentech, Inc. (Grant #: N3944). AEJ has received funding from the National Institutes of Health. DBD serves as a consultant for Daiichi Sankyo, Beckmann Coulter, Mylan and has received research support from Radiometer, Alere, DOD and the National Institutes of Health. CK is a consultant for Diagnostica Stago, Siemens Healthcare and has received grant funding to his institution from Diagnostica Stago, Siemens Healthcare, the Harvard Milton Fund and the National Institutes of Health. Publisher Copyright: {\textcopyright} 2014, Springer Science+Business Media New York.",

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AU - Peitz, Geoffrey W.

AU - Nordenholz, Kristen E.

AU - Courtney, D. Mark

AU - Kabrhel, Christopher

AU - Jones, Alan E.

AU - Rondina, Matthew T.

AU - Diercks, Deborah B.

AU - Klinger, James R.

AU - Kline, Jeffrey A.

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PY - 2015/11/30

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N2 - Acute pulmonary embolism (PE) can diminish patient quality of life (QoL). The objective was to test whether treatment with tenecteplase has an independent effect on a measurement that reflects QoL in patients with submassive PE. This was a secondary analysis of an 8-center, prospective randomized controlled trial, utilizing multivariate regression to control for predefined predictors of worsened QoL including: age, active malignancy, history of PE or deep venous thrombosis (DVT), recurrent PE or DVT, chronic obstructive pulmonary disease and heart failure. QoL was measured with the physical component summary (PCS) of the SF-36. Analysis included 76 patients (37 randomized to tenecteplase, 39 to placebo). Multivariate regression yielded an equation f(8, 67), P < 0.001, with R2 = 0.303. Obesity had the largest effect on PCS (β = −8.6, P < 0.001), with tenecteplase second (β = 4.73, P = 0.056). After controlling for all interactions, tenecteplase increased the PCS by +5.37 points (P = 0.027). In patients without any of the defined comorbidities, the coefficient on the tenecteplase variable was not significant (−0.835, P = 0.777). In patients with submassive PE, obesity had the greatest influence on QoL, followed by use of fibrinolysis. Fibrinolysis had a marginal independent effect on patient QoL after controlling for comorbidities, but was not significant in patients without comorbid conditions.

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Contribution of fibrinolysis to the physical component summary of the SF-36 after acute submassive pulmonary embolism

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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