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AIM: To study the effect of of intracoronally targeted recombinant human urokinase combined with percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) with high thrombus burden. METHODS: In this retrospective analysis study, 85 AMI patients with heavy thrombus burden admitted to Wuhu Second people's Hospital for percutaneous coronary intervention (PCI) from November 2020 to November 2022 were divided into observation group (n=37) and control group (n=48) according to different treatment methods.Recombinant human urokinase were used for coronary intervention in observation group. The control group was not treated with recombinant human urokinase. The myocardial injury markers troponinI (cTnI) and creatine kinase (CK) within 24 h after PCI, the percentage of segment resolution≥50% 1 h after PCI, intraoperative coronary lesions blood flow, the incidence of adverse cardiovascular events (MACE) during hospitalization, and cardiac function indexleft ventricular end diastolic (LVED), fractional shortening (FS), left ventricular ejection fraction (LVEF) level change one month discharge were compared between the two groups after PCI. RESULTS: After PCI, the levels value of cTnI and creatine kinase in the observation group at within 24 h after PCI were (69.35±16.31) ng/mL vs. (80.52±15.20) ng/mL, (3 136.27±1 952.52) U/L vs. (4 554.51±1 982.34) U/L, which were significantly lower than those in the control group (P0.05) CONCLUSION: Intracoronally targeted application of recombinant human urokinase combined with percutaneous coronary intervention (PCI) has a significant effect on AMI with heavy thrombus burden, which can effectively improve cardiac function, coronary blood flow and myocardial reperfusion, and reduce myocardial damage without increasing the risk of MACE
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Objective@#To evaluate the effect of intracoronary injection of recombinant human urokinase on plasma P-selectin in AMI patients with no-reflow during acute PCI.@*Methods@#Ninety-two patients with acute ST-segment elevation myocardial infarction or acute non-ST-segment elevation myocardial infarction admitted to Center Hospital of Changchun City in January 2017 and December 2018 were randomly divided into two groups: 47 patients with intracoronary injection of sodium nitroprusside as control group and 45 patients with intracoronary injection of recombinant human urokinase as treatment group. Among them, 58 were males and 36 were females. The onset time was less than 12 h. The basic data, serum P-selectin, myocardial perfusion index and major adverse cardiovascular events were compared between the two groups.@*Results@#In the treatment group, the corrected TIMI frame number, instant TIMI grade 3 blood flow, myocardial chromogenic grade 3 blood flow, myocardial necrosis marker CTnI, serum P-selectin were significantly lower than those in the control group: 31.26 ± 4.58 vs. 35.15 ± 6.25, 71.1%(32/45) vs. 51.1%(24/47), 64.4%(29/45) vs. 55.3%(26/47), (28.46 ± 3.95) ng/ml vs. (30.18 ± 3.47) ng/ml, (13.26 ± 4.58) ng/ml vs. (15.04 ± 3.98) ng/ml, and EF function was better. In the control group. The incidence of major adverse cardiac events in the treatment group was lower than that in the control group within one month after operation, but there was no statistical significance.@*Conclusions@#There is no reflux in patients with AMI during PCI. Intracoronary injection of recombinant human urokinase can improve myocardial perfusion without reflux and has no effect on fibrinolytic system in vivo. It does not increase the risk of systemic hemorrhage and the incidence of serious adverse cardiovascular events.
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Objective To evaluate the effect of intracoronary injection of recombinant human urokinase on plasma P-selectin in AMI patients with no-reflow during acute PCI. Methods Ninety-two patients with acute ST-segment elevation myocardial infarction or acute non-ST-segment elevation myocardial infarction admitted to Center Hospital of Changchun City in January 2017 and December 2018 were randomly divided into two groups: 47 patients with intracoronary injection of sodium nitroprusside as control group and 45 patients with intracoronary injection of recombinant human urokinase as treatment group. Among them, 58 were males and 36 were females. The onset time was less than 12 h. The basic data, serum P- selectin, myocardial perfusion index and major adverse cardiovascular events were compared between the two groups. Results In the treatment group, the corrected TIMI frame number, instant TIMI grade 3 blood flow, myocardial chromogenic grade 3 blood flow, myocardial necrosis marker CTnI, serum P-selectin were significantly lower than those in the control group: 31.26 ± 4.58 vs. 35.15 ± 6.25, 71.1%(32/45) vs. 51.1%(24/47), 64.4%(29/45) vs. 55.3%(26/47), (28.46 ± 3.95) ng/ml vs. (30.18 ± 3.47) ng/ml, (13.26 ± 4.58) ng/ml vs. (15.04 ± 3.98) ng/ml, and EF function was better. In the control group. The incidence of major adverse cardiac events in the treatment group was lower than that in the control group within one month after operation, but there was no statistical significance. Conclusions There is no reflux in patients with AMI during PCI. Intracoronary injection of recombinant human urokinase can improve myocardial perfusion without reflux and has no effect on fibrinolytic system in vivo. It does not increase the risk of systemic hemorrhage and the incidence of serious adverse cardiovascular events.