Efficacy and Safety of a Pharmaco-Invasive Strategy Using Half-Dose Recombinant Human Prourokinase in Patients with ST-Segment Elevation Myocardial Infarction During Hospitalization

Author:

Dou Jie1ORCID,Gao Jie1,Yang Huihui1,Guo Ruoling1,Jiang Chao1,Guo Jingtao2,Luo Donglei2

Affiliation:

1. School of Medicine, Chengde Medical University, Chengde, Hebei, China

2. Department of Cardiology, Chengde Central Hospital/Second Clinical College of Chengde Medical University, Chengde, Hebei, China

Abstract

This study investigated the efficacy and safety of pharmaco-invasive strategy with half-dose recombinant human prourokinase (PHDP) during hospitalization for patients with ST-segment elevation myocardial infarction (STEMI) to provide references for the treatment of STEMI. Patients with STEMI who fulfilled the inclusion and exclusion criteria and attended Chengde Central Hospital, Hebei Province, China, between September 3, 2019, and December 28, 2021, were included in this study. The experimental group received PHDP and the control group underwent primary percutaneous coronary intervention (PPCI). This study enrolled 150 patients with STEMI, 75 in the experimental group and 75 in the control group. Coronary angiography revealed successful thrombolysis in 64 (85.33%) patients. Compared with the control group, the experimental group had shorter first medical contact-reperfusion time ( P < 0.001), less slow flow/no-reflow ( P < 0.001), and a lower utilization rate of Tirofiban ( P < 0.001). Validity endpoints: no statistically significant differences between the two groups. Safety endpoints: no statistically significant differences between bleeding and major adverse cardiovascular and cerebrovascular events (MACCEs), but the experimental group was more prone to arrhythmias ( P = 0.040), particularly premature ventricular beats (PVB) ( P = 0.008). In conclusion, the efficacy and safety of PHDP in the treatment of patients with STEMI were positive. Complete epicardial and myocardial reperfusion rates, risk for bleeding during hospitalization, and incidence of MACCEs were similar to those of the PPCI strategy. Although the PHDP group has a higher incidence of PVB, it does not increase the incidence of malignant arrhythmia. This study aimed to provide a new therapeutic strategy for the treatment of STEMI in hospitals without adequate PPCI resources condition.

Funder

Medical Science Research Project of Hebei Province

S&T Program of Chengde

Publisher

SAGE Publications

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