R.R. Baliga/LinkedIn
Sep 7, 2026, 14:17
R.R. Baliga: Stable – But not Safe – Should We Intervene before Patients Crash?
R.R. Baliga, Editor-In-Chief of Textbook of Internal Medicine: Helping You Become a Great Doc, shared on LinkedIn:
“Stable—but not safe. Should we intervene before patients crash?
PRAGUE-26 randomized 558 patients with intermediate-high–risk acute pulmonary embolism to catheter-directed low-dose alteplase and anticoagulation or anticoagulation alone.
The 7-day composite of death, recurrent PE, or cardiorespiratory decompensation/collapse fell from 6.8% to 0.7% (RR 0.10; P less than 0.001)—mainly through fewer episodes of decompensation.
Major bleeding was not increased, although 2 intracranial hemorrhages occurred with thrombolysis.
The emerging paradigm: prevent the crash rather than rescue it.”
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