Effect of intracoronary injection of recombinant human prourokinase on no-reflow and prognosis in STEMI patients after emergency PCI
Gao Jingfang
Li Li
Geng Xuebin
Ma Yi
Abstract：Objective To investigate the effect of intracoronary injection of recombinant human prourokinase(rhpro-UK)through a microcatheter on no-reflow phenomenon and prognosis after emergency PCI for acute STEMI.Methods A total of 185 acute STEMI patients undergoing emergency PCI in our hospital from January 2018 to January 2019 were enrolled,and randomly di-vided into control group(92 cases)and observation group(93 cases).The control group was given an intracoronary injection of 10 μg/kg tirofiban via a microcatheter within 3 min after coronary angiography,and the observation group received a combined injection of 10 mg rhpro-UK on the basis of above treatment.TIMI(Thrombolysis in Myocardial Infarction)flow grade and corrected TIMI frame count(CTFC),myocardial injury markers,left ventricular ejection fraction(LVEF),incidences of major adverse cardiovascular events(MACE)and bleeding events were observed and compared between the two groups.Results The observation group had significantly higher per-centage of TIMI flow 3(79.57％vs 59.78％),and lower CTFC(28.94±3.93 frames vs 35.12± 5.20 frames)and total incidence of MACE after PCI(8.60％vs 26.09％)when compared with the control group(P＜0.01).At 7 d after PCI,cTnI and CK-MB levels were obviously lower,and LVEF was notably higher in the observation group than the control group(P＜0.01).The main bleeding events included gastrointestinal bleeding,urinary tract bleeding,gingival bleeding and nasal mucosal bleeding in the 2 groups,and the total bleeding incidence was 6.52％in the control group,and 6.45％in the observation group(P＞0.05).Conclusion Intracoronary injection of Ⅱb/Ⅲa receptor antagonist and rhpro-UK through a microcatheter shows a positive effect on no-reflow in STEMI patients after emergency PCI,and is beneficial for improving prognosis without increasing the risk of bleeding.
Keywords：ST elevation myocardial infarctionprognosisno-reflow phenomenonpercutaneous coronary interventionurokinase-type plasminogen activator
Publication Date：2024-04-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 385-388 )