Table 4. Randomized trials of systemic thrombolysis in patients with intermediate risk of pulmonary embolism^111-114.

	MAPPET-3	MOPETT	TOPCOAT	PEITHO
Publication year	2002	2013	2014	2014
Patient no.	256	121	83	1006
PE severity	RV dysfunction by echocardiograph, right heart catheterization, or elec-trocardiogram	≥ 2 lobar involvement by computed tomographic pulmonary angiography or lung ventilation/perfusion scintigraphy	RV strain by echocardiography or an elevated troponin or brain natriuretic peptide level	RV dysfunction by echocardiography or spiral compute tomography and an elevated troponin
Thrombolysis regimen	Alteplase 100 mg over 2 hours (a 10-mg bolus, followed by a 90-mg intravenous infusion)	Alteplase 50 mg over 2 hours (a 10-mg bolus, followed by a 40-mg intravenous infusion) if weight ≥ 50 kg or 0.5 mg/kg over 2 hours (a 10-mg bolus, followed by the reminder intravenous infusion) if weight < 50 kg	A single weight-based intravenous bolus of tenecteplase	A single weight-based intravenous bolus of tenecteplase
Initial anticoagulation regimen	UFH adjusted to maintain the activated partial thromboplastin time at 2.0 to 2.5 times the upper limit of normal	UFH or enoxaparin	Low-molecular-weight heparin	UFH adjusted to maintain the activated partial thromboplastin time at 2.0 to 2.5 times the upper limit of normal
Primary endpoint	In-hospital death or clinical deterioration that required an escalation of treatment	The development of pulmonary hypertension at intermediate-term follow up	Death, circulatory shock, intubation or major bleeding within 5 days or recurrent PE, poor functional capacity or an SF-36 Physical Component Summary < 30 at 90-day follow-up	Death or hemodynamic decompensation within 7 days
Efficacy	14% absolute reduction in the primary endpoint	41% absolute reduction in the primary endpoint	No difference	3% absolute reduction in the primary endpoint
Major bleeding	No difference	No difference	Not reported	9% absolute increase

PE, pulmonary embolism; RV, right ventricle; UFH, unfractionated heparin.