Effect of intracoronary tenecteplase on efficacy and major adverse cardiovascular events after percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction
Wei Yansheng
Niu Yifang
Wang Jianming
Long Jingning
Zhang Zhenling
Zhang Junbiao
Zhang Yongchun
Liu Hui
Abstract：Objective To observe the impact of intracoronary injection of tenecteplase on therapeutic effect,cardiac function and major adverse cardiovascular events(MACE)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 103 patients with STEMI who were admitted to the First Affiliated Hospital of Xinxiang Medical Universi-ty for percutaneous coronary intervention(PCI)from April 2022 to August 2024 were selected as the study objects and randomly divided into the control group(51 cases)and the experimental group(52 cases).The control group received routine PCI treatment,and the experimental group received intracoronary injection of tenecteplase on the basis of the control group.The postoperative ef-ficacy,cardiac function 72 h after surgery,levels of myocardial injury markers and occurrence of MACEs before and after surgery were observed and compared between the two groups.Results There was no significant difference in thrombolysis in myocardial infarction(TIMI)blood flow grading between the two groups after the surgery(Z=1.701,P>0.05).The TIMI thrombus classification,CTFC and STR of the experimental group were better than those of the control group(t/Z=2.192,2.681,2.208,all P<0.05).The LVEDD,LVEF,E/A of the control group and the experimental group were respectively(39.67±3.58)mm vs(37.86±3.49)mm,(55.63±4.72)% vs(57.49±4.58)%,(1.18±0.25)vs(1.30±0.27)after the surgery for 72 hours,better than(45.38±4.06)mm vs(45.52±4.18)mm,(51.82±4.26)% vs(51.48±4.13)%,(1.09±0.26)vs(1.08±0.31)before the surgery;the above indexes of the experimen-tal group were better than those of the control group(t=8.605,6.387,5.020,8.910,2.601,3.894,2.598,2.030,3.339,all P<0.05).The levels of cTnI and CK-MB of the control group and the experimental group were respectively(18.71±5.15)ng·mL-1 vs(15.28±4.33)ng·mL-1,(152.50±35.33)U·L-1 vs(128.07±24.79)U·L-1 after the surgery for 24 hours,higher than(12.74±3.85)ng·mL-1 vs(12.92±3.71)ng·mL-1,(86.32±18.47)U·L-1 vs(84.95±17.62)U·L-1 before the surgery;the above indexes of the experimental group were lower than those of the control group(t=7.365,4.012,11.816,6.385,3.661,4.069,all P<0.05).The incidence of MACEs was 5.77% (3 cases)in the experimental group,lower than 19.61% (10 cases)in the control group,and there was significant difference between the two groups(χ2=4.471,P<0.05).Conclusion Intracoronary injection of tenecteplase can effectively improve the myocardial perfusion and myocardial ischemia of patients,reduce the level of myocardial enzyme profile,and also decrease the incidence of MACEs.
Keywords：TenecteplaseAcute ST-segment elevation myocardial infarctionPercutaneous coronary interventionIntracoronary injectionCardiac function
Publication Date：2025-07-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 594-598 )