Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction
Abstract Background The efficacy and safety of low-pressure balloon pre-dilatation before intracoronary pro-urokinase (pro-UK) in preventing no-reflow during percutaneous coronary intervention (PCI) remains unknown. This study aimed to evaluate the clinical outcomes of intracoronary pro-UK combined...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-02699-7 |
| _version_ | 1797219589163057152 |
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| author | Shicheng Yu Haoxuan Jia Shengkai Ding Mengda Zhang Fengyun Li Pan Xu Yuan Tian Lingling Ma Lijie Gong Jun Feng Zhaojin Sun Fudong Qian Hui Li |
| author_facet | Shicheng Yu Haoxuan Jia Shengkai Ding Mengda Zhang Fengyun Li Pan Xu Yuan Tian Lingling Ma Lijie Gong Jun Feng Zhaojin Sun Fudong Qian Hui Li |
| author_sort | Shicheng Yu |
| collection | DOAJ |
| description | Abstract Background The efficacy and safety of low-pressure balloon pre-dilatation before intracoronary pro-urokinase (pro-UK) in preventing no-reflow during percutaneous coronary intervention (PCI) remains unknown. This study aimed to evaluate the clinical outcomes of intracoronary pro-UK combined with low-pressure balloon pre-dilatation in patients with anterior ST-segment-elevation myocardial infarction (STEMI). Methods This was a randomized, single-blind, investigator-initiated trial that included 179 patients diagnosed with acute anterior STEMI. All patients were eligible for PCI and were randomized into two groups: intracoronary pro-UK combined with (ICPpD group, n = 90) or without (ICP group, n = 89) low-pressure balloon pre-dilatation. The main efficacy endpoint was complete epicardial and myocardial reperfusion. The safety endpoints were major adverse cardiovascular events (MACEs), which were analyzed at 12 months follow-up. Results Patients in the ICPpD group presented significantly higher TIMI myocardial perfusion grade 3 (TMPG3) compared to those in the ICP group (77.78% versus 68.54%, P = 0.013), and STR ≥ 70% after PCI 30 min (34.44% versus 26.97%, P = 0.047) or after PCI 90 min (40.0% versus 31.46%, P = 0.044). MACEs occurred in 23 patients (25.56%) in the ICPpD group and in 32 patients (35.96%) in the ICP group. There was no difference in hemorrhagic complications during hospitalization between the groups. Conclusion Patients with acute anterior STEMI presented more complete epicardial and myocardial reperfusion with adjunctive low-pressure balloon pre-dilatation before intracoronary pro-UK during PCI. Trial registration 2019xkj213. |
| first_indexed | 2024-04-24T12:36:03Z |
| format | Article |
| id | doaj.art-4e96beffaf724de6b4776c74a8c5db46 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-24T12:36:03Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-4e96beffaf724de6b4776c74a8c5db462024-04-07T11:30:15ZengBMCJournal of Cardiothoracic Surgery1749-80902024-04-0119111310.1186/s13019-024-02699-7Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarctionShicheng Yu0Haoxuan Jia1Shengkai Ding2Mengda Zhang3Fengyun Li4Pan Xu5Yuan Tian6Lingling Ma7Lijie Gong8Jun Feng9Zhaojin Sun10Fudong Qian11Hui Li12Department of Cardiology, Lu’an Hospital of Anhui Medical UniversityGraduate School of Bengbu Medical CollegeDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityDepartment of Cardiology, Lu’an Hospital of Anhui Medical UniversityAbstract Background The efficacy and safety of low-pressure balloon pre-dilatation before intracoronary pro-urokinase (pro-UK) in preventing no-reflow during percutaneous coronary intervention (PCI) remains unknown. This study aimed to evaluate the clinical outcomes of intracoronary pro-UK combined with low-pressure balloon pre-dilatation in patients with anterior ST-segment-elevation myocardial infarction (STEMI). Methods This was a randomized, single-blind, investigator-initiated trial that included 179 patients diagnosed with acute anterior STEMI. All patients were eligible for PCI and were randomized into two groups: intracoronary pro-UK combined with (ICPpD group, n = 90) or without (ICP group, n = 89) low-pressure balloon pre-dilatation. The main efficacy endpoint was complete epicardial and myocardial reperfusion. The safety endpoints were major adverse cardiovascular events (MACEs), which were analyzed at 12 months follow-up. Results Patients in the ICPpD group presented significantly higher TIMI myocardial perfusion grade 3 (TMPG3) compared to those in the ICP group (77.78% versus 68.54%, P = 0.013), and STR ≥ 70% after PCI 30 min (34.44% versus 26.97%, P = 0.047) or after PCI 90 min (40.0% versus 31.46%, P = 0.044). MACEs occurred in 23 patients (25.56%) in the ICPpD group and in 32 patients (35.96%) in the ICP group. There was no difference in hemorrhagic complications during hospitalization between the groups. Conclusion Patients with acute anterior STEMI presented more complete epicardial and myocardial reperfusion with adjunctive low-pressure balloon pre-dilatation before intracoronary pro-UK during PCI. Trial registration 2019xkj213.https://doi.org/10.1186/s13019-024-02699-7STEMIPCIPro-urokinaseEfficacySafety |
| spellingShingle | Shicheng Yu Haoxuan Jia Shengkai Ding Mengda Zhang Fengyun Li Pan Xu Yuan Tian Lingling Ma Lijie Gong Jun Feng Zhaojin Sun Fudong Qian Hui Li Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction Journal of Cardiothoracic Surgery STEMI PCI Pro-urokinase Efficacy Safety |
| title | Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction |
| title_full | Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction |
| title_fullStr | Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction |
| title_full_unstemmed | Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction |
| title_short | Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction |
| title_sort | efficacy and safety of intracoronary pro urokinase combined with low pressure balloon pre dilatation during percutaneous coronary intervention in patients with anterior st segment elevation myocardial infarction |
| topic | STEMI PCI Pro-urokinase Efficacy Safety |
| url | https://doi.org/10.1186/s13019-024-02699-7 |
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