Key result
Pharmacoinvasive staphylokinase is recommended for STEMI when primary PCI delays exceed 120 minutes.
Why the study?
When primary PCI cannot be performed within 120 minutes in STEMI patients, a pharmacoinvasive strategy is recommended, requiring continued research to determine its current place, optimize thrombolysis, and improve prognosis.
A pharmacoinvasive strategy using domestic staphylokinase is highlighted as a viable and recommended option for STEMI patients in Russia who cannot receive timely primary PCI.
Supports pharmacoinvasive strategy when primary PCI exceeds 120 min in STEMI; extends RCT evidence for alternative reperfusion.
In patients with ST-elevation myocardial infarction, primary percutaneous coronary intervention should be performed within 120 minutes after diagnosis if possible. Timely revascularization helps to preserve left ventricular function, minimizing myocardial damage, which subsequently reduces disability and mortality. There are patients for whom this approach cannot be implemented within the specified time frame for a number of reasons. In such a situation, a pharmacoinvasive strategy is recommended, which involves thrombolytic therapy as the first stage. Current treatment strategies for myocardial infarction have been compared many times. An undoubted advantage in Russia is the availability of domestic staphylokinase agent, which has a good efficacy and safety profile, meeting the requirements for fibrin specificity. Thus, research determining the current place of pharmacoinvasive strategy should be continued to optimize thrombolysis and improve the prognosis in patients with myocardial infarction.
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Oleynikov et al. (2025) conducted a review in ST-elevation myocardial infarction. Pharmacoinvasive strategy was evaluated. A pharmacoinvasive strategy using domestic staphylokinase is recommended for STEMI patients in Russia who cannot undergo primary percutaneous coronary intervention within 120 minutes.
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