Effects of Intracoronary Pro-urokinase or Tirofiban on Coronary Flow During Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Multi-Center, Placebo-Controlled, Single-Blind, Randomized Clinical Trial
机构：[1]Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China,[2]Department of Cardiology, Putuo District Central Hospital, Shanghai, China,[3]Department of Cardiology, Tenth Hospital, Shanghai, China,[4]Department of Cardiology, Changhai Hospital, Shanghai, China,[5]Department of Cardiology, Fengxian District Central Hospital, Shanghai, China,[6]Department of Cardiology, Shanghai Chest Hospital, Shanghai, China,[7]Department of Cardiology, Tongren Hospital, Shanghai, China,[8]Department of Cardiology, Minhang District Central Hospital, Shanghai, China,[9]Department of Cardiology, Sixth Hospital, Shanghai, China,[10]Department of Cardiology, Changzheng Hospital, Shanghai, China,[11]Department of Cardiology, Shanghai East Hospital, Shanghai, China
Background: To determine whether intracoronary pro-urokinase or tirofiban improves myocardial reperfusion during primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). Methods: The study included patients with acute STEMI presenting within 12 h of symptoms at 11 hospitals in China between November 2015 and July 2017. Patients were randomized to receive selective intracoronary infusion of recombinant pro-urokinase (20 mg), tirofiban (10 mu g/kg), or saline (20 mL) proximal to the infarct-related lesion over a 3-min period before stent implantation during primary PCI. The primary outcome was final corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) after PCI. Results: This study included 345 patients. Initial angiography identified a high-grade thrombus (TIMI 4-5) in 80% of patients. Final CTFC after PCI was significantly lower in the pro-urokinase (P < 0.001) and tirofiban (P < 0.001) groups than in the saline group and similar between the pro-urokinase and tirofiban groups (P >0.05). The pro-urokinase (P = 0.008) and tirofiban groups (P = 0.022) had more complete ST-segment resolution at 2 h and lower peak creatine kinase-MB levels after PCI than the saline group (P = 0.006 and P = 0.023). The 30-day incidence of major adverse cardiac events was 4.5% in the pro-urokinase group, 3.4% in the tirofiban group, and 2.6% in the saline group. The incidence of in-hospital TIMI major bleeding events was low and comparable between groups. Conclusions: Adjunctive intracoronary pro-urokinase or tirofiban given before stent implantation during primary PCI improves myocardial reperfusion without increasing the incidence of major bleeding events.
基金：
National Key Research and Development Program of China [2016YFC1301203]; Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China
第一作者机构：[1]Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China,
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通讯作者：
推荐引用方式(GB/T 7714)：
Huang Dong,Qian Juying,Liu Zongjun,et al.Effects of Intracoronary Pro-urokinase or Tirofiban on Coronary Flow During Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Multi-Center, Placebo-Controlled, Single-Blind, Randomized Clinical Trial[J].FRONTIERS IN CARDIOVASCULAR MEDICINE.2021,8:doi:10.3389/fcvm.2021.710994.
APA：
Huang, Dong,Qian, Juying,Liu, Zongjun,Xu, Yawei,Zhao, Xianxian...&Ge, Junbo.(2021).Effects of Intracoronary Pro-urokinase or Tirofiban on Coronary Flow During Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Multi-Center, Placebo-Controlled, Single-Blind, Randomized Clinical Trial.FRONTIERS IN CARDIOVASCULAR MEDICINE,8,
MLA：
Huang, Dong,et al."Effects of Intracoronary Pro-urokinase or Tirofiban on Coronary Flow During Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Multi-Center, Placebo-Controlled, Single-Blind, Randomized Clinical Trial".FRONTIERS IN CARDIOVASCULAR MEDICINE 8.(2021)
