zabmedvestnikЗабайкальский медицинский вестникTransbaikalian Medical Bulletin1998-6173Читинская государственная медицинская академия10.52485/19986173_2026_2_218zabmedvestnik-518Research ArticleНАУЧНЫЕ ОБЗОРЫ, ИЛЛЮСТРИРОВАННЫЕ КЛИНИЧЕСКИМ НАБЛЮДЕНИЕМSCIENTIFIC REVIEWS ILLUSTRATED WITH CLINICAL CASE STUDIESНЕИММУНОГЕННАЯ СТАФИЛОКИНАЗА В ТЕРАПИИ ТРОМБОЭМБОЛИИ ЛЁГОЧНОЙ АРТЕРИИ ПРОМЕЖУТОЧНО-ВЫСОКОГО РИСКАNON-IMMUNOGENIC STAPHYLOKINASE IN THE TREATMENT OF INTERMEDIATE–HIGH- RISK PULMONARY EMBOLISMhttps://orcid.org/0000-0002-3333-2058ШапошниковБ. С.ShaposhnikovB. S.

Шапошников Борис Сергеевич, ассистент кафедры детских инфекционных болезней 

355017, г. Ставрополь, ул. Мира, 310; Ставропольский край, 356146, г. Изобильный, ул. Колхозная 2

Boris Sergeevich Shaposhnikov, Assistant of the Department of Pediatric Infectious Diseases 

310 Mira St., Stavropol, Russia, 355017; 2 Kolkhoznaya St., Izobilny, Stavropol Territory, Russia, 356146

mackisaew@yandex.ruhttps://orcid.org/0000-0002-9990-7272ОбединА. Н.ObedinA. N.

Обедин Александр Николаевич, д.м.н., заведущий кафедрой анестезиологии, реаниматологии с курсом ДПО 

355017, г. Ставрополь, ул. Мира, 310

Alexander Nikolaevich Obedin, Doctor of Medical Sciences, Head of the Department of Anesthesiology, Intensive Care with the course of additional professional education 

310 Mira St., Stavropol, Russia, 355017

volander@mail.ruhttps://orcid.org/0000-0003-4705-3823БыковЮ. В.BykovYu. V.

Быков Юрий Витальевич, к.м.н., доцент кафедры анестезиологии, реаниматологии с курсом ДПО

355017, г. Ставрополь, ул. Мира, 310;  355002, г. Ставрополь, ул. Семашко 3

 

Yuri Vitalievich Bykov, Candidate of Medical Sciences, Associate Professor of the Department of Anesthesiology and Intensive Care with a course of additional professional education

310 Mira St., Stavropol, Russia, 355017; 3 Semashko St., Stavropol, Russia, 355002

yubykov@gmail.comhttps://orcid.org/0009-0004-5332-4161УшмудинЕ. В.UshmudinE. V.

Ушмудин Евгений Валентинович, врач-анестезиолог-реаниматолог отделения интенсивной терапии, анестезиологии и реанимации 

Ставропольский край, 356146, г. Изобильный, ул. Колхозная 2

Evgeny Valentinovich Ushmudin, anesthesiologist-resuscitator of the intensive Therapy, Anesthesiology and intensive Care

2 Kolkhoznaya St., Izobilny, Stavropol Territory, Russia, 356146

ushmudin1@mail.ruhttps://orcid.org/0000-0002-0723-6994ТетеринаМ. А.TeterinaM. A.

Тетерина Марина Александровна, ассистент кафедры внутренних болезней с курсом кардиологии и функциональной диагностики им. акад. В.С. Моисеева

117198, г. Москва, ул. Миклухо-Маклая, д. 6

Marina Alexandrovna Teterina, Assistant of the Department of Internal Medicine with a course in Cardiology and Functional Diagnostics named after Academician V.S. Moiseev 

6 Miklukho-Maklaya St., Moscow, Russia, 117198

tetmarina@mail.ruhttps://orcid.org/0000-0001-6818-8845МерайИ.MeraiI.

Мерай Имад, профессор кафедры внутренних болезней с курсом кардиологии и функциональной диагностики им. акад. В.С. Моисеева; заведующий отделением реанимации для кардиологических больных университетской клинической больницы им В.В. Виноградова

117198, г. Москва, ул. Миклухо-Маклая, д. 6; 117292, г. Москва, ул. Вавилова, д. 61 стр. 1

Imad Merai, Professor of the Department of Internal Medicine with a course in Cardiology and Functional Diagnostics named after Academician V.S. Moiseeva, Head of the Intensive Care Unit for Cardiac Patients at the V.V. Vinogradov University Clinical Hospital 

6 Miklukho-Maklaya St., Moscow, Russia, 117198; 61 Vavilov St., building 1 Moscow, Russia, 117292

 

imadmerai@yahoo.comФГБОУ ВО «Ставропольский государственный медицинский университет» Министерства здравоохранения РФ; ГБУЗ Ставропольского края «Изобильненская районная больница» Министерства здравоохранения РФРоссияStavropol State Medical University; Izobilnenskaya District HospitalRussian FederationФГБОУ ВО «Ставропольский государственный медицинский университет» Министерства здравоохранения РФРоссияStavropol State Medical UniversityRussian FederationФГБОУ ВО «Ставропольский государственный медицинский университет» Министерства здравоохранения РФ; ГБУЗ Ставропольского края «Ставропольская детская краевая клиническая больница» Министерства здравоохранения РФРоссияStavropol State Medical University; Stavropol Regional Children's Clinical Hospital, 3Russian FederationГБУЗ Ставропольского края «Изобильненская районная больница» Министерства здравоохранения РФРоссияIzobilnenskaya District HospitalRussian FederationФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»РоссияPatrice Lumumba Peoples' Friendship University of RussiaRussian FederationФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»; Университетская клиническая больница им. В.В. Виноградова (филиал) ФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»РоссияPatrice Lumumba Peoples' Friendship University of Russia; V. V. Vinogradov University Clinical Hospital – branch of the Patrice Lumumba Peoples' Friendship University of RussiaRussian Federation20263007202602218229Copyright © Шапошников Б.С., Обедин А.Н., Быков Ю.В., Ушмудин Е.В., Тетерина М.А., Мерай И., 20262026Шапошников Б.С., Обедин А.Н., Быков Ю.В., Ушмудин Е.В., Тетерина М.А., Мерай И.Shaposhnikov B.S., Obedin A.N., Bykov Y.V., Ushmudin E.V., Teterina M.A., Merai I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.zabmedvestnik.ru/jour/article/view/518

Тромбоэмболия лёгочной артерии (ТЭЛА) промежуточно-высокого риска характеризуется сохранной гемодинамикой при наличии признаков дисфункции правого желудочка (ПЖ) и повышенных кардиоспецифических биомаркеров, что ассоциируется с риском ранней декомпенсации. Вопрос о целесообразности системной тромолитической терапии (ТЛТ) в данной категории пациентов остаётся дискуссионным в связи с необходимостью баланса между реперфузионным эффектом и риском геморрагических осложнений. В обзоре представлены современные данные о роли антикоагулянтной терапии, системной и катетер-направленной реперфузии, а также обсуждается потенциальное место неиммуногенной стафилокиназы.

В качестве клинической иллюстрации приведено наблюдение пациентки с ТЭЛА промежуточно- высокого риска и признаками ухудшения на фоне антикоагулянтной терапии, у которой системная ТЛТ неиммуногенной стафилокиназой обеспечила полный лизис тромботических масс, восстановление функции ПЖ и отсутствие геморрагических осложнений. Полученные данные подтверждают необходимость дальнейших исследований для уточнения критериев отбора пациентов и оптимальной стратегии лечения.

Intermediate–high-risk pulmonary embolism (PE) is characterized by preserved systemic hemodynamics in the presence of right ventricular (RV) dysfunction and elevated cardiac-specific biomarkers, which are associated with a risk of early clinical deterioration. The appropriateness of systemic thrombolytic therapy (TLT) in this patient population remains controversial, as it requires careful balancing of the potential reperfusion benefits against the risk of hemorrhagic complications. This review summarizes current evidence regarding anticoagulant therapy, systemic and catheter-directed reperfusion strategies, and discusses the potential role of non-immunogenic staphylokinase.

As a clinical illustration, we present a case of a patient with intermediate–high-risk PE who demonstrated clinical worsening despite anticoagulant therapy and was treated with systemic TLT using non-immunogenic staphylokinase, resulting in complete thrombus resolution, restoration of RV function, and absence of hemorrhagic complications. These findings highlight the need for further research to refine patient selection criteria and optimize treatment strategies.

тромбоэмболия легочной артерии промежуточно-высокого рисканеиммуногенная стафиллокиназасистемная тромболитическая терапиягеморрагические осложненияintermediate-high-risk pulmonary embolismnonimmunogenic staphylokinasesystemic thrombolytic therapyhemorrhagic complicationsReferencesKonstantinides S.V., Meyer G., Becattini C. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020. 41. 543–603. DOI: 10.1093/EURHEARTJ/EHZ405.Konstantinides S.V., Meyer G., Becattini C. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020. 41. 543–603. DOI: 10.1093/EURHEARTJ/EHZ405.de Wit K., D’Arsigny C.L. et al. Risk stratification of acute pulmonary embolism. J Thromb Haemost. 2023. 21. 3016–3023. DOI: 10.1016/J.JTHA.2023.05.003.de Wit K., D’Arsigny C.L., et al. Risk stratification of acute pulmonary embolism. J Thromb Haemost. 2023. 21. 3016–3023. DOI: 10.1016/J.JTHA.2023.05.003.Becattini C., Agnelli G., Lankeit M. et al. Contemporary Management and Clinical Course of Acute Pulmonary Embolism: The COPE Study. Thromb Haemost. 2023. 123. 613–626. DOI: 10.1055/A-2031-3859.Becattini C., Agnelli G., Lankeit M. et al. Contemporary Management and Clinical Course of Acute Pulmonary Embolism: The COPE Study. Thromb Haemost. 2023. 123. 613–626. DOI: 10.1055/A-2031-3859.El-Bouri W., Sanders A., Lip G.Y.H. et al. Predicting acute and long-term mortality in a cohort of pulmonary embolism patients using machine learning. Eur J Intern Med. 2023. 118. 42–48. DOI: 10.1016/J.EJIM.2023.07.012.El-Bouri W., Sanders A., Lip G.Y.H. et al. Predicting acute and long-term mortality in a cohort of pulmonary embolism patients using machine learning. Eur J Intern Med. 2023. 118. 42–48. DOI: 10.1016/J.EJIM.2023.07.012.Humbert M., Kovacs G., Hoeper M.M. et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022. 43. 3618–3731. DOI: 10.1093/EURHEARTJ/EHAC237.Humbert M., Kovacs G., Hoeper M.M. et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022. 43. 3618–3731. DOI: 10.1093/EURHEARTJ/EHAC237.Latsios G., Mantzouranis E., Kachrimanidis I. et al. Recent advances in risk stratification and treatment of acute pulmonary embolism. World J Cardiol. 2025. 17. 104983. DOI: 10.4330/WJC.V17.I5.104983.Latsios G., Mantzouranis E., Kachrimanidis I. et al. Recent advances in risk stratification and treatment of acute pulmonary embolism. World J Cardiol. 2025. 17. 104983. DOI: 10.4330/WJC.V17.I5.104983.Mirambeaux R., León F., Bikdeli B. et al. Intermediate-High Risk Pulmonary Embolism. TH Open. 2019. 3. e356–e363. DOI: 10.1055/S-0039-3400302.Mirambeaux R., León F., Bikdeli B. et al. Intermediate-High Risk Pulmonary Embolism. TH Open. 2019. 3. e356–e363. DOI: 10.1055/S-0039-3400302.Yuriditsky E., Zhang R.S., Ahuja T. et al. The latest in the management of pulmonary embolism. Breathe (Sheff). 2025. 2. 240100. doi: 10.1183/20734735.0100-2024.Yuriditsky E., Zhang R.S., Ahuja T. et al. The latest in the management of pulmonary embolism. Breathe (Sheff). 2025. 2. 240100. doi: 10.1183/20734735.0100-2024.Bikdeli B., Muriel A., Rodríguez C. et al. High-Sensitivity vs Conventional Troponin Cutoffs for Risk Stratification in Patients With Acute Pulmonary Embolism. JAMA Cardiol. 2024. 9. 64–70. DOI: 10.1001/JAMACARDIO.2023.4356.Bikdeli B., Muriel A., Rodríguez C. et al. High-Sensitivity vs Conventional Troponin Cutoffs for Risk Stratification in Patients With Acute Pulmonary Embolism. JAMA Cardiol. 2024. 9. 64–70. DOI: 10.1001/JAMACARDIO.2023.4356.Weekes A.J., Fraga D.N., Belyshev V. et al. Intermediate-risk pulmonary embolism: echocardiography predictors of clinical deterioration. Crit Care. 2022. 26. 160. DOI: 10.1186/S13054-022-04067-8.Weekes A.J., Fraga D.N., Belyshev V. et al. Intermediate-risk pulmonary embolism: echocardiography predictors of clinical deterioration. Crit Care. 2022. 26. 160. DOI: 10.1186/S13054-022-04067-8.Zuin M., Rigatelli G., Bongarzoni A. et al. Mean arterial pressure predicts 48 h clinical deterioration in intermediate-high risk patients with acute pulmonary embolism. Eur Heart J Acute Cardiovasc Care. 2023. 12. 80–86. DOI: 10.1093/EHJACC/ZUAD014.Zuin M., Rigatelli G., Bongarzoni A. et al. Mean arterial pressure predicts 48 h clinical deterioration in intermediate-high risk patients with acute pulmonary embolism. Eur Heart J Acute Cardiovasc Care. 2023. 12. 80–86. DOI: 10.1093/EHJACC/ZUAD014.Zhao Y., Zhang S., Yang J. et al. Optimal initial duration of low molecular weight heparin lead-in before direct oral anticoagulants for short-term outcomes of hospitalized patients with non-high-risk acute pulmonary embolism. QJM. 2024. 117. 781–788. DOI: 10.1093/QJMED/HCAE083.Zhao Y., Zhang S., Yang J. et al. Optimal initial duration of low molecular weight heparin lead-in before direct oral anticoagulants for short-term outcomes of hospitalized patients with non-high-risk acute pulmonary embolism. QJM. 2024. 117. 781–788. DOI: 10.1093/QJMED/HCAE083.Stevens S.M., Woller S.C., Kreuziger L.B. et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021. 160. E545–E608. DOI: 10.1016/J.CHEST.2021.07.055.Stevens S.M., Woller S.C., Kreuziger L.B. et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021. 160. E545–E608. DOI: 10.1016/J.CHEST.2021.07.055.Zhang S., Xi L., Zhang Z. et al. Tenecteplase in pulmonary embolism patients: a meta-analysis and systematic review. Front Med. 2022. 9. 860565. DOI: 10.3389/FMED.2022.860565.Zhang S., Xi L., Zhang Z. et al. Tenecteplase in pulmonary embolism patients: a meta-analysis and systematic review. Front Med. 2022. 9. 860565. DOI: 10.3389/FMED.2022.860565.Mathew D., Seelam S., Bumrah K. et al. Systemic thrombolysis with newer thrombolytics vs anticoagulation in acute intermediate risk pulmonary embolism: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2023. 23. 482. DOI: 10.1186/S12872-023-03528-W.Mathew D., Seelam S., Bumrah K. et al. Systemic thrombolysis with newer thrombolytics vs anticoagulation in acute intermediate risk pulmonary embolism: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2023. 23. 482. DOI: 10.1186/S12872-023-03528-W.Rozenbaum Z. Revisiting Systemic Thrombolysis in Acute Pulmonary Embolism. JACC Adv. 2024. 3. 100923. DOI: 10.1016/J.JACADV.2024.100923.Rozenbaum Z. Revisiting Systemic Thrombolysis in Acute Pulmonary Embolism. JACC Adv. 2024. 3. 100923. DOI: 10.1016/J.JACADV.2024.100923.Zhang R.S., Maqsood M.H., Sharp A.S.P. et al. Efficacy and safety of anticoagulation, catheter-directed thrombolysis, or systemic thrombolysis in acute pulmonary embolism. JACC Cardiovasc Interv. 2023. 16. 2644–2651. DOI: 10.1016/J.JCIN.2023.07.042.Zhang R.S., Maqsood M.H., Sharp A.S.P. et al. Efficacy and safety of anticoagulation, catheter-directed thrombolysis, or systemic thrombolysis in acute pulmonary embolism. JACC Cardiovasc Interv. 2023. 16. 2644–2651. DOI: 10.1016/J.JCIN.2023.07.042.Zimmermann L., Laufs U., Petros S. et al. Outcome after thrombolysis in patients with intermediate high- risk pulmonary embolism: a propensity score analysis. J Emerg Med. 2022. 62. 378–389. DOI: 10.1016/J.JEMERMED.2021.12.013.Zimmermann L., Laufs U., Petros S. et al. Outcome after thrombolysis in patients with intermediate high- risk pulmonary embolism: a propensity score analysis. J Emerg Med. 2022. 62. 378–389. DOI: 10.1016/J.JEMERMED.2021.12.013.Iannaccone M., Franchin L., Russo F. et al. Mortality across treatment strategies in intermediate-to-high risk pulmonary embolism in the modern era: A meta-analysis of observational studies and RCTs. Int J Cardiol. 2023. 387: 131127. DOI: 10.1016/j.ijcard.2023.131127.Iannaccone M., Franchin L., Russo F. et al. Mortality across treatment strategies in intermediate-to-high risk pulmonary embolism in the modern era: A meta-analysis of observational studies and RCTs. Int J Cardiol. 2023. 387:131127. DOI: 10.1016/j.ijcard.2023.131127.Planer D., Yanko S., Matok I. et al. Catheter-directed thrombolysis compared with systemic thrombolysis and anticoagulation in patients with intermediate- or high-risk pulmonary embolism: systematic review and network meta-analysis. CMAJ. 2023. 195 (24): E833–E843. DOI: 10.1503/cmaj.220960.Planer D., Yanko S., Matok I. et al. Catheter-directed thrombolysis compared with systemic thrombolysis and anticoagulation in patients with intermediate- or high-risk pulmonary embolism: systematic review and network meta-analysis. CMAJ. 2023. 195(24):E833–E843. DOI: 10.1503/cmaj.220960.Pietrasik A., Gąsecka A., Szarpak Ł. et al. Catheter-Based Therapies Decrease Mortality in Patients With Intermediate and High-Risk Pulmonary Embolism: Evidence From Meta-Analysis of 65,589 Patients. Front Cardiovasc Med. 2022. 9: 861307. DOI: 10.3389/fcvm.2022.861307.Pietrasik A., Gąsecka A., Szarpak Ł. et al. Catheter-Based Therapies Decrease Mortality in Patients With Intermediate and High-Risk Pulmonary Embolism: Evidence From Meta-Analysis of 65,589 Patients. Front Cardiovasc Med. 2022. 9:861307. DOI: 10.3389/fcvm.2022.861307.Lauder L., Pérez Navarro P., Götzinger F. et al. Mechanical thrombectomy in intermediate- and high-risk acute pulmonary embolism: hemodynamic outcomes at three months. Respir Res. 2023. 24 (1): 257. DOI: 10.1186/s12931-023-02552-w.Lauder L., Pérez Navarro P., Götzinger F. et al. Mechanical thrombectomy in intermediate- and high-risk acute pulmonary embolism: hemodynamic outcomes at three months. Respir Res. 2023. 24(1):257. DOI: 10.1186/s12931-023-02552-w.Chandra V.M., Nacca N., Ross A. et al. Mechanical aspiration thrombectomy for the treatment of pulmonary embolism: A systematic review and meta-analysis. Vasc Med. 2022. 27 (6): 574–584. DOI: 10.1177/1358863X221124681.Chandra V.M., Nacca N., Ross A. et al. Mechanical aspiration thrombectomy for the treatment of pulmonary embolism: A systematic review and meta-analysis. Vasc Med. 2022. 27(6):574–584. DOI: 10.1177/1358863X221124681.Khandhar S., Jaber W., Bunte M.C. et al. Longer-Term Outcomes Following Mechanical Thrombectomy for Intermediate- and High-Risk Pulmonary Embolism: 6-Month FLASH Registry Results. J Soc Cardiovasc Angiogr Interv. 2023. 2 (4): 101000. DOI: 10.1016/j.jscai.2023.101000.Khandhar S., Jaber W., Bunte M.C. et al. Longer-Term Outcomes Following Mechanical Thrombectomy for Intermediate- and High-Risk Pulmonary Embolism: 6-Month FLASH Registry Results. J Soc Cardiovasc Angiogr Interv. 2023. 2 (4): 101000. DOI: 10.1016/j.jscai.2023.101000.Bruno E.S., Mujer M.T.P., Desai P.V. et al. A Meta-analysis of Standard Versus Ultrasound-Assisted Catheter-Directed Thrombolysis in the Management of Acute Pulmonary Embolism. J Soc Cardiovasc Angiogr Interv. 2023. 2 (1): 100514. DOI: 10.1016/j.jscai.2022.100514.Bruno E.S., Mujer M.T.P., Desai P.V. et al. A Meta-analysis of Standard Versus Ultrasound-Assisted Catheter-Directed Thrombolysis in the Management of Acute Pulmonary Embolism. J Soc Cardiovasc Angiogr Interv. 2023. 2 (1): 100514. DOI: 10.1016/j.jscai.2022.100514.Hobohm L., Farmakis I.T., Keller K. et al. Pulmonary embolism response team (PERT) implementation and its clinical value across countries: a scoping review and meta-analysis. Clin Res Cardiol. 2023. 112 (10): 1351–1361. DOI: 10.1007/s00392-022-02077-0.Hobohm L., Farmakis I.T., Keller K. et al. Pulmonary embolism response team (PERT) implementation and its clinical value across countries: a scoping review and meta-analysis. Clin Res Cardiol. 2023. 112 (10): 1351–1361. DOI: 10.1007/s00392-022-02077-0.Fleitas Sosa D., Lehr A.L., Zhao H. et al. Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis. Eur Respir Rev. 2022. 31 (165): 220023. DOI: 10.1183/16000617.0023-2022.Fleitas Sosa D., Lehr A.L., Zhao H. et al. Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis. Eur Respir Rev. 2022. 31 (165): 220023. DOI: 10.1183/16000617.0023-2022.Терещенко С.Н., Яровая Е.Б., Леонтьев С.Г. и др. Неиммуногенная стафилокиназа у пациентов с массивной тромбоэмболией легочных артерий промежуточно-высокого риска: протокол многоцентрового двойного слепого рандомизированного плацебо-контролируемого исследования ФОРПЕ-2. Российский кардиологический журнал. 2025. 30 (2). 6291. DOI: 10.15829/1560-4071- 2025-6291.Tereshchenko S.N., Yarovaya E.B., Leontyev S.G. et al. Non-immunogenic staphylokinase in patients with massive intermediate-high risk pulmonary embolism: protocol of a multicenter double-blind randomized placebo-controlled FORPE-2 study. Russian Journal of Cardiology. 2025. 30 (2). 6291. DOI: 10.15829/1560-4071-2025-6291.Кириенко А.И., Леонтьев С.Г., Яровая Е.Б. и др. Неиммуногенная стафилокиназа — тромболитический препарат в лечении массивной тромбоэмболии легочной артерии: результаты клинического исследования ФОРПЕ. Российский кардиологический журнал. 2024. 29 (11). 6157. DOI: 10.15829/1560-4071-2024-6157.Kirienko A.I., Leontyev S.G., Yarovaya E.B. et al. Non-immunogenic staphylokinase as a thrombolytic drug in the treatment of massive pulmonary embolism: results of the FORPE clinical study. Russian Journal of Cardiology. 2024. 29 (11). 6157. DOI: 10.15829/1560-4071-2024-6157.

The authors declare that there are no conflicts of interest present.