Efficacy and safety of a facilitated percutaneous coronary intervention with half-dose recombinant staphylokinase in ST-segment elevation myocardial infarction
10.3969/j.issn.1004-8812.2025.08.002
- VernacularTitle:半剂量重组葡激酶易化经皮冠状动脉介入治疗在急性ST段抬高型心肌梗死中的有效性及安全性
- Author:
Tian-yu WU
1
;
Wen-hao ZHANG
;
Peng-sheng CHEN
;
Chen LI
;
Tian WU
;
Zhan LÜ
;
Tong WANG
;
Kun LIU
;
Zhi-wen TAO
;
Xiao-xuan GONG
;
Liang YUAN
;
Yong LI
;
Bo CHEN
;
Xin CHEN
;
Zeng-guang CHEN
;
Nai-quan YANG
;
Yuan-yuan SANG
;
Xiao-yan WANG
;
Bai-hong LI
;
Li ZHU
;
Guo-yu WANG
;
Xin ZHAO
;
Chuan LU
;
Jun JIANG
;
Rui-na HAO
;
Chun-jian LI
Author Information
1. 南京医科大学第一附属医院心血管内科,江苏 南京 210029
- Publication Type:Journal Article
- Keywords:
Acute ST-segment elevation myocardial infarction;
Percutaneous coronary intervention;
Thrombolysis;
Recombinant staphylokinase
- From:
Chinese Journal of Interventional Cardiology
2025;33(8):431-438
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.
