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| Transient and long term efficacy of intracoronary recombinant human prourokinase administered on STEMI patients with primary PCI |
| Lei Da-zhou, Wang Yan, Zhou Fan, Li Shi-xun |
| Department of Cardiology, Xinxiang Central Hospital, Xinxiang 453000, China |
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Abstract Objective Patients with ST-segment elevation myocardial infarction (STEMI) who were given PCI often have myocardial reperfusion injury, which is associated with poor outcomes. This study aims to elucidate the efficacy and safety of pharmacoinvasive therapy by using prourokinase (prouk) in patients with STEMI. Methods A randomized study which enrolled patients from Xinxiang Central Hospital was conducted. Patients were randomly assigned to accept routine primary PCI or prouk-PCI. The primary end points were the angiographic parameters, including thrombolysis in myocardial infarction (TIMI) flow grade, TIMI frame count, and myocardial blush grade. Secondary endpoints were incidence of major adverse cardiac events (MACCE, defined as death from all causes, reinfarction, revascularization, or rehospitalization due to new or worsening congestive heart failure) at 30 days and 1 year. Results One hundred and seventeen eligible patients were enrolled, of whom 59 were randomized to the prouk-PCI group. Significantly more patients in the prouk-PCI group than in the PCI group had better TIMI frame count after PCI (32±7 vs. 41±12, P<0.001). At 1-year follow-up, there was a trend that patients in the prouk-PCI group had less chances to have MACE (1.69% vs. 8.62%, P=0.0138) or be readmitted to hospital due to new or worsening congestive heart failure (5.09% vs. 13.79%, P=0.0361). Conclusion A strategy of emergent PCI preceded by fibrinolysis with prouk results in a better myocardial perfusion in infarct-related artery compared with primary PCI alone.
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| About author:: Lei Da-zhou, E-mail:leidazhou2006@163.com |
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