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BRIEF RESEARCH REPORT article

Front. Med.

Sec. Pulmonary Medicine

This article is part of the Research TopicInnovative Approaches in Pulmonary Hypertension Prevention and Treatment Using Natural CompoundsView all articles

Correlation between Anticoagulant Initiation Time and Thrombolysis at 30 Days after Anticoagulation Therapy in Patients with Pulmonary Embolism

Provisionally accepted
zhou  yaojiezhou yaojieyang  danrongyang danrongLiu  YiLiu Yi*
  • Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China

The final, formatted version of the article will be published soon.

Objective: This study aimed to investigate the correlation between anticoagulant initiation time and thrombolysis at 30 days after anticoagulation therapy in patients with pulmonary embolism (PE). Methods: Patients with PE who were hospitalized in the Department of Respiratory Medicine were enrolled. Based on computed tomography pulmonary angiography (CTPA) performed 30 days after anticoagulation therapy, patients were categorized into the complete thrombolysis group (n=112) and the incomplete thrombolysis group (n=93). A retrospective analysis was conducted on risk factors, clinical characteristics, and auxiliary examinations. Spearman's correlation analysis was used to assess the association between anticoagulant initiation time and thrombolysis at 30 days. Receiver operating characteristic (ROC) curve analysis was applied to determine the optimal cut-off point for anticoagulation initiation time in PE. Results: The proportion of patients with complete thrombolysis at 30 days was 54.63% (112 of 205). Spearman's correlation analysis indicated a significant negative correlation between anticoagulant initiation time and thrombolysis at 30 days (Rs=-0.411, P<0.001). ROC curve analysis showed that anticoagulant initiation time predicted thrombolysis at 30 days (AUC: 0.736, 95% CI: 0.668–0.804, P<0.001). The Youden index was 0.071, and the optimal cut-off point for anticoagulant initiation time was <6.5 days, which was associated with the best therapeutic effect. Conclusion: Anticoagulant initiation time, PAOI, DVT, and malignant tumors were negatively correlated with thrombolysis at 30 days after anticoagulation therapy. Thrombus absorption within 1 month was significantly improved when anticoagulant therapy was initiated within 6.5 days.

Keywords: Pulmonary Embolism, Pulmonary artery obstruction index, anticoagulation, d-dimer, thrombolysis

Received: 22 Aug 2025; Accepted: 27 Oct 2025.

Copyright: © 2025 yaojie, danrong and Yi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Liu Yi, liuyi830401@126.com

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