A randomized study of prourokinase during primary percutaneous coronary intervention in acute ST‐segment elevation myocardial infarction

Wang, Geng; Zhang, Qi; Liu, Jingmin; Xiang, Tian; Zhen, Libo; Da, Song; Yang, Ying; Meng, Hui; Wang, Yafang; Chen, Jianjun

doi:10.1111/joic.12461

Cited by 28 publications

(26 citation statements)

References 37 publications

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“…Recent reports suggested that CP normalized hyperlipimedia, improving vascular function and other pathological processes (Niu et al, 2000; Zhao et al, 2010; Guo et al, 2016; Han et al, 2017; Lim et al, 2017). Recombinant human prourokinase (proUK) (Geng et al, 2018; Hao et al, 2018; Zhao et al, 2018) is a novel type of thrombolytic drug for clinical application in thrombotic diseases, which selectively activates fibrinogen on the surface of the thrombus, and has less side effect of bleeding (Sasahara et al, 1995; Verstraete, 1999). However, no study is reported as to the effect of CP or proUK on progression of atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Cardiotonic Pills Plus Recombinant Human Prourokinase Ameliorates Atherosclerotic Lesions in LDLR–/– Mice

Deng

Sun

et al. 2019

Front. Physiol.

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AimThis study was to explore the protective effects of cardiotonic pills (CP) or/and recombinant human prourokinase (proUK)on the atherosclerosis and the potential underlying mechanism.Methods and ResultsAtherosclerosis was induced in LDLR–/– mice by high fat diet contained 20% lard and 0.5% cholesterol. Daily oral administration of CP (130 mg/kg) or/and intravenous injection of proUK (2.5 mg/kg, twice a week) began at 8 weeks after feeding with high fat diet and continued for 4 weeks. CP alone treatment markedly decreased plasma triglyceride, but did not ameliorate atherosclerosis plaque. No effect was observed for proUK alone on any endpoints tested. CP plus proUK induced a significantly reduction in the atherosclerotic lesions, along with decreased levels of total cholesterol, triglyceride in the plasma. CP plus proUK inhibited the elevated hepatic total cholesterol and triglyceride in high fat diet-fed LDLR–/– mice, up-regulating the expressions of ATP-binding cassette gene 5 and 8, and adipose triglyceride lipase. In the aorta, CP plus proUK inhibited the expression of scavenger receptor A and CD36 in LDLR–/– mice. In addition, we observed that systemic inflammation was inhibited, manifested downregulation of plasma macrophage inflammatory protein-1α and intercellular cell adhesion molecule-1.ConclusionCP plus proUK effectively attenuated atherosclerosis plaque in LDLR–/– mice, which is associated with normalizing the lipid metabolism in the liver and aorta, reducing phagocytosis of receptor-mediated modified-LDL uptake and inhibiting systemic inflammation.

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Section: Introductionmentioning

confidence: 99%

Cardiotonic Pills Plus Recombinant Human Prourokinase Ameliorates Atherosclerotic Lesions in LDLR–/– Mice

Deng

Sun

et al. 2019

Front. Physiol.

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“…In a recent study [11] , in patients with STEMI complicated with a long delay in PCI, emergency PCI combined with rhPro-UK thrombolysis showed significantly better myocardial perfusion of IRAs than direct PCI. Geng et al [11] showed that the intracoronary injection of rhPro-UK through a balloon catheter could effectively improve myocardial perfusion in patients with STEMI. Our results show that the postoperative blood flow TIMI classification in the Pro-UK group was significantly higher than that before operation.…”

Section: Discussionmentioning

confidence: 95%

The intracoronary injection of recombinant human prourokinase in emergency interventional therapy for high thrombus load during ST-segment elevation myocardial infarction: a retrospective cohort study

Qin¹,

Xuelin²,

Zhou³

et al. 2020

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Aim: The clinical effect of the injection of recombinant human prourokinase to infarction-related arteries during percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients who have slow reflow/no reflow was investigated. Methods: Data from STEMI patients who underwent emergency PCI at the Chest Pain Center of the First People's Hospital of Changde City from April 2017 to December 2018 were collected for analysis. Results: Whether the ST segment had decreased by more than 50% at 90 min and whether the creatine kinase isoenzyme and cardiac troponin I had decreased by more than 50% were investigated. There were no significant differences in the indexes of color Doppler echocardiography (left ventricular ejection fraction, left ventricular enddiastolic diameter, ventricular aneurysm, and ventricular thrombus) within seven days after surgery and in the ventricular tachycardia/ventricular fibrillation between the two groups (P > 0.05). There was no significant difference in major adverse cardiovascular event between the two groups within one month after surgery (P > 0.05), but, there were significant differences in the Thrombolysis in Myocardial Infarction (TIMI) classification, corrected TIMI frame count, creatine kinase peak value, and the third-degree atrioventricular block (P < 0.05).

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“…Thus, boosting efficacy and safety of PCI in STEMI is constantly a major concern in clinical practice. In addition, the use of prourokinase in myocardial infarction including STEMI has been tested in various clinical trials and studies, which altogether present a good efficacy and safety of prourokinase as a thrombolytic agent [16,17]. Therefore, we performed this randomized clinical trial which evaluated the efficacy and safety of intracoronary prourokinase during PCI for STEMI treatment, and the main findings were as follows: 1) IMR was decreased in intracoronary prourokinase group compared with control group; 2) TMPG, CK peak value, CK-MB peak value, cTnI and STR were more satisfactory in intracoronary prourokinase group than those in control group; 3) the cardiac function including LVEF, LVEDd and WMSI were better in intracoronary prourokinase group compared with control group; 4) no difference regarding hemorrhagic AEs and MACE incidences was found between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of intracoronary prourokinase during percutaneous coronary intervention in treating ST-segment elevation myocardial infarction patients: a randomized, controlled study

Feng

et al. 2020

BMC Cardiovasc Disord

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Background: Prourokinase is a single-chain plasminogen activator presenting with fewer hemorrhagic complications and reduced reocclusion rate compared with the conventional fibrinolytic agents in patients with coronary artery disease. However, prourokinase intracoronary injection during PCI for treating patients with STsegment elevation myocardial infarction (STEMI) is rarely investigated. Therefore, this study aimed to evaluate the efficacy and safety of intracoronary prourokinase during the percutaneous coronary intervention (PCI) in treating STEMI patients. Methods: Fifty STEMI patients who underwent primary PCI were consecutively enrolled and randomly assigned to intracoronary prourokinase group (N = 25) or control group (N = 25). During the primary PCI procedure, patients in the intracoronary prourokinase group received 10 ml prourokinase injection, while patients in control group received 10 ml saline injection as control. The primary endpoints were coronary physiological indexes, the secondary endpoints were angiographic assessments, myocardial infarct size/reperfusion assessment, cardiac function evaluations, major adverse coronary events (MACEs) and hemorrhagic complications. All patients were followed up for 3 months.

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A randomized study of prourokinase during primary percutaneous coronary intervention in acute ST‐segment elevation myocardial infarction

Abstract: Intracoronary administration of prourokinase via balloon catheter during primary PCI effectively improved myocardial perfusion in STEMI patients.

Cited by 28 publications

References 37 publications

Cardiotonic Pills Plus Recombinant Human Prourokinase Ameliorates Atherosclerotic Lesions in LDLR–/– Mice

Cardiotonic Pills Plus Recombinant Human Prourokinase Ameliorates Atherosclerotic Lesions in LDLR–/– Mice

The intracoronary injection of recombinant human prourokinase in emergency interventional therapy for high thrombus load during ST-segment elevation myocardial infarction: a retrospective cohort study

Efficacy and safety of intracoronary prourokinase during percutaneous coronary intervention in treating ST-segment elevation myocardial infarction patients: a randomized, controlled study

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