The Efficacy and Safety of Pharmacoinvasive Therapy with Prourokinase for Acute ST‐Segment Elevation Myocardial Infarction Patients with Expected Long Percutaneous Coronary Intervention‐Related Delay

• Published in: Cardiovascular therapeutics 2013-10, Vol.31 (5), p.285-290
• Main Authors: Han, Ya‐Ling, Liu, Jian‐Ning, Jing, Quan‐Min, Ma, Ying‐Yan, Jiang, Tie‐Min, Pu, Kui, Zhao, Rui‐Ping, Zhao, Xin, Liu, Hai‐Wei, Xu, Kai, Wang, Geng, Wang, Bin, Sun, Rui‐Hua, Wang, Jie
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular system; Coronary heart disease; Electrocardiography; Female; Fibrinolytic Agents - therapeutic use; Heart; Humans; Interventional cardiology; Male; Medical sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - drug therapy; Myocarditis. Cardiomyopathies; Percutaneous Coronary Intervention; Pharmacoinvasive therapy; Pharmacology. Drug treatments; Prourokinase; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; Thrombolysis; Time Factors; Urokinase-Type Plasminogen Activator - adverse effects; Urokinase-Type Plasminogen Activator - therapeutic use
• ISSN: 1755-5914; 1755-5922
• DOI: 10.1111/1755-5922.12020

Summary Objectives To elucidate the efficacy and safety of pharmacoinvasive therapy by using prourokinase (prouk) in patients with ST‐segment elevation myocardial infarction (STEMI). Background Patients with STEMI often have long percutaneous coronary intervention (PCI)‐related delays due to various reasons, which are associated with poor outcomes. Methods A randomized study which enrolled patients from four centers in China 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 (MACE, 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 ninety‐seven eligible patients were enrolled, of whom 100 were randomized to the prouk‐PCI group. Significantly more patients in the prouk‐PCI group than in the PCI group had an opened infarct‐related artery on arrival in the catheterization laboratory (48% vs. 21%, P = 0.0002) and better TIMI frame count after PCI (33 ± 6 vs. 40 ± 10, P