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Safety and efficacy study of prourokinase injection during primary percutaneous coronary intervention in acute

Wenlong Jiang1, Xiaoshuan Xiong, Xiaohui Du

  • 1Department of Cardiovascular, Shenzhen Yantian People's Hospital, Shenzhen, China.

Coronary Artery Disease
|April 21, 2020
PubMed

Insights

Intracoronary prourokinase improved ST-segment elevation myocardial infarction reperfusion without increasing bleeding. This treatment enhanced myocardial perfusion during primary percutaneous coronary interventions.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Acute ST-segment elevation myocardial infarction (STEMI) requires rapid reperfusion.
  • Primary percutaneous coronary interventions (PCI) are standard, but improving microvascular reperfusion remains a challenge.

Purpose of the Study:

  • To assess the efficacy and safety of intracoronary prourokinase administration during primary PCI in STEMI patients.
  • To evaluate its impact on myocardial perfusion and clinical outcomes.

Main Methods:

  • A randomized trial comparing intracoronary prourokinase (n=125) versus saline (control, n=135) during primary PCI in STEMI.
  • Prourokinase or saline was delivered distally via balloon catheter post-dilatation.
  • Evaluated infarct size, myocardial reperfusion (ST-resolution), cardiac function, bleeding, and major adverse cardiovascular events (MACE) at 6 months.

Main Results:

  • Intracoronary prourokinase significantly increased ST-segment resolution (>50%) compared to control (P < 0.05).
  • Patients receiving prourokinase showed lower serum CK, CK-MB, and troponin I levels (P < 0.05).
  • No significant differences in bleeding complications or 6-month MACE were observed between groups (P > 0.05).

Conclusions:

  • Intracoronary prourokinase administration via balloon catheter during primary PCI effectively enhances myocardial perfusion in STEMI.
  • This approach is safe, with no increase in bleeding complications.
  • It offers a potential adjunctive therapy to improve outcomes in STEMI patients undergoing primary PCI.
Abstract

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