Influence of low-dose aletplase in patients with acute myocardial infarction with severe thrombotic burden during percutaneous coronary intervention
Xu Haojun
Yu Zongliang
Gu Ming
Zhu Jianzhong
Abstract：Objective To study the influence of intracoronary injection of low-dose aletplase in patients with acute myocardial infarction (AMI) with severe thrombotic burden.Methods AMI patients (n=60) with severe thrombotic burden (length of thrombus being 2 times of vessel diameter) received emergency percutaneous coronary intervention (PCI) were chosen from Kunshan Hospital affiliated to Jiangsu University from Jan.2016to June 2018.The patients were given aspirin (300 mg) and ticagrelor (180 mg) before PCI.All patients were randomly divided into control group given intracoronary injection of normal saline (5 mg-10 mg), and observation group given intracoronary injection of low-dose aletplase (5 mg-10 mg, each n=30).After thrombolysis, dual antiplatelet therapy (DAPT) was used in 2 groups (clopidogrel in 75 mg and aspirin in 100 mg) once a day for 1 y, andβ-receptor blocker and statins were routinely administrated after PCI.The postoperative TIMI blood flow grading, improvement of corrected TIMI frame count (CTFC), degree of ST-segment depression 2 h after PCI, and postdischarge incidence of major adverse cardiovascular events (MACE, including Killip＞Ⅲgrade, bleeding, malignant arrhythmia and sudden cardiac death) were compared between 2 groups after 30 d.Results The baseline data had no significant difference between 2 groups (P＞0.05).There were 21 male cases and 9 female cases (aged from 48 to69 and average age=61.5±6.6) in observation group, and 22 male cases and 8 female cases (aged from 49 to 68 and average age=61.1±6.5) in control group.There was no significant difference in complications between 2 groups (P＞0.05).The postoperative TIMI blood flow grading was significantly better in observation group than that in control group (P＜0.05).The rate of 2-h ST-segment depression by 50％was higher in observation group than that in control group (83.3％vs.63.3％, P＜0.05).The incidence of MACE was lower in observation group than that in control group (P＜0.05) during in-hospital and 30 d after discharge.Conclusion During PCI in patients with AMI with severe thrombotic burden, intracoronary injection of low-dose aletplase can further improve TIMI flow grade and reduce incidence of MACE, which can be widely used in clinical practice.
Keywords：AletplaseSevere thrombotic burdenAcute myocardial infarctionEmergency interventional therapy
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1520-1522,1533 )