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Controversies in Internal Medicine
October 24, 2005

Rebuttal

Author Affiliations
 

ANN B.NATTINGERMD, MPH

Arch Intern Med. 2005;165(19):2204. doi:10.1001/archinte.165.19.2204

The opposition to thrombolysis by Thabut and Logeart is based on their fundamental miscalculation that the mortality from acute PE is only 1.5%. The death rate from acute PE is actually 10-fold higher (15%) when consecutive patients with PE are tracked.1 Thabut and Logeart were also misled by reading only sanitized clinical trials with dozens of exclusion criteria. These trials skim off the healthiest segment of the PE population. Physicians who evaluate patients in the emergency department or intensive care unit recognize that PE is more deadly than acute myocardial infarction.

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