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| Efficacy of different intracoronary administration methods of prourokinase in patients with acute ST-segment elevation myocardial infarction |
| Cao Ya-li, Jiang Zhi-an, Chen Tao, Zhang Xiao-guang, Zhao Shu-jian, Yin Hong-shan, Wang Tao |
| Department of Cardiology, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China |
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Abstract Objective To compare the effects of two prourokinase administration methods on myocardial perfusion and short-term prognosis after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI), and the two modes of administration refer to one-time intracoronary prourokinase injection and fractional intracoronary prourokinase injection in PCI. Methods A total of 102 STEMI patients undergoing emergency PCI were enrolled and randomly divided into two groups: forty-nine patients in group A received three dose of intracoronary recombinant human prourokinase injection after guide-wire crossing (4 mL), balloon dilation (3 mL) and stenting (3 mL), a total of 20 mg, other fifty-three patients in group B received one dose (10 mL) of intracoronary recombinant human prourokinase injection only after guide-wire crossing, also 20 mg. Thrombolysis in myocardial infarction (TIMI) flow classification, TIMI myocardial perfusion grading (TMPG), ST-segment resolution (STR) at 90 minutes after operation and left ventricular ejection fraction (LVEF) one day and 7 days after operation were all used to evaluate myocardial perfusion. Bleeding events within 7 days and major adverse cardiac events (MACE) within 3 months after operation were also compared. Results There were no significant differences in TIMI flow classification and TMPG before PCI and the LVEF on the first day after PCI between the two groups (P>0.05). After PCI in infarct-related artery (IRA), the TIMI flow classification (P=0.038) and TMPG (P=0.015) improved more significantly in group A compared with group B, and the STR in 90 minutes after operation in group A was obviously better than that in group B (P=0.032). 7 days after operation, the LVEF in group A was also slightly higher than that in group B (P=0.001). There was no statistical differences in the incidence of hemorrhage 7 days after operation and the incidence of MACE within 3 months after operation between the two groups (P>0.05). Conclusion For patients with acute STEMI who underwent PCI, the administration of recombinant human urokinase in multiple times could better improve the myocardial perfusion without increasing the incidence of hemorrhage and MACE compared with the administration in only one time, and ultimately improve the prognosis.
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Corresponding Authors:
Jiang Zhi-an, E-mail: doctorjiangzhian@163.com
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