Key result
Low-dose prourokinase cuts corrected TIMI frame count ~20% vs. placebo in STEMI.
Why the study?
The efficacy and safety of low-dose prourokinase administration during primary PCI for STEMI patients with a high thrombus burden were not established.
RCT (n=390)
Double-blind
Simple randomized group allocation
No
Answers are grounded in this paper and cite their sources.
May enhance perfusion surrogates in high-thrombus STEMI; leaves open effects on clinical outcomes.
OBJECTIVE: To evaluate the efficacy and safety of low-dose prourokinase (pro-UK) administration during primary percutaneous coronary intervention (PCI) for the treatment of acute ST-segment elevation myocardial infarction (STEMI) in patients with a high thrombus burden. METHODS: A prospective, randomized controlled trial was conducted at the Inner Mongolia People's Hospital, China. Patients with STEMI and a high thrombus burden who underwent thrombus aspiration and primary PCI were randomly allocated to pro-UK administration or control groups. The primary endpoint was corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC). RESULTS: There were no significant differences in the baseline demographics or clinical characteristics of the two groups. The CTFC, tissue myocardial perfusion grade, ST-segment resolution, and myocardial blush grade of the pro-UK group were significantly better than those of the control group. In addition, after 30 days of follow-up, the pro-UK group had better cardiac function and perfusion than the control group. There were no differences in the clinical outcomes or incidence of hemorrhage. CONCLUSIONS: : Chinese Clinical Trial Registry (ChiCTR1900022290).
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Cao et al. (2022) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) with high thrombus burden (n=390). Low-dose prourokinase (pro-UK) vs. 0.9% sodium chloride was evaluated on Postprocedural corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) (p=<0.01). Low-dose prourokinase administration during primary PCI significantly improved postprocedural corrected TIMI frame count (25.17 vs. 31.56 frames, p<0.01) compared to placebo in STEMI patients with high thrombus burden.
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