Abstract
Objective To compare the efficacy and safety of recombinant human prourokinase (rhPro-UK) and alteplase for thrombolytic therapy in acute ST-segment elevation myocardial infarction (STEMI) and to analyze the related factors affecting efficacy. Methods From January 2017 to December 2019, 100 patients diagnosed with STEMI were selected and randomly divided into the control group (n = 50) and the observation group (n = 50). Based on conventional treatments, the control group was treated with alteplase, and the observation group was treated with rhPro-UK, and both were treated for 7 days. After treatment, the vascular recanalization, left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and left ventricular ejection fraction (LVEF) were compared. The bleeding and major adverse cardiovascular events (MACE) were recorded in both groups. According to the patient's vascular recanalization, it was divided into two subgroups: recanalization group and occlusion group. Multiple logistic regression models were used to analyze the related factors that affect the efficacy. Results The recanalization rate of the observation group (96.00%) was higher than that of the control group (84.00%) (P < 0.05). After treatment, LVDs and LVEDD in both groups were lower than those before treatment, and LVEF was higher than that before treatment. The LVDs and LVEDD in the observation group were lower than those in the control group, and the LVEF was higher than that in the control group (P < 0.05). The incidence of bleeding in the observation group (2.00%) was lower than that in the control group (12.00%), and the incidence of MACE (4.00%) was lower than that in the control group (16.00%) (P < 0.05). Univariate analysis showed that age, smoking history, diabetes history, myocardial infarction history, infarct location, and intravenous thrombolysis time were related to the efficacy after treatment (P < 0.05). Multivariate logistic analysis showed that age, history of diabetes, vascular infarction site, and venous thrombolysis time were independent influencing factors after treatment (P < 0.05). Conclusion Both rhPro-UK and alteplase thrombolytic therapy can effectively recanalize blood vessels and improve the cardiac function of patients with STEMI. However, rhPro-UK has better effect than alteplase and is safer and worth promoting. The curative effect is related to age, diabetes history, vascular infarction site, and venous thrombolysis time.
Highlights
ST-segment elevation myocardial infarction (STEMI) refers to patients with coronary artery atherosclerosis and plaque shedding, resulting in blood vessel blockage, resulting in a decrease in the heart’s own blood supply and leading to myocardial ischemic necrosis [1, 2]
STEMI is mainly caused by the occurrence of myocardial ischemia and necrosis due to the rupture and shedding of unstable plaques in the coronary arteries, which leads to obstruction of the coronary arteries
Compared with percutaneous coronary intervention (PCI), intravenous thrombolysis has the advantages of simplicity, convenience, and speed and can effectively improve the treatment effect of STEMI patients [12, 13]
Summary
ST-segment elevation myocardial infarction (STEMI) refers to patients with coronary artery atherosclerosis and plaque shedding, resulting in blood vessel blockage, resulting in a decrease in the heart’s own blood supply and leading to myocardial ischemic necrosis [1, 2]. Intravenous thrombolysis and percutaneous coronary intervention (PCI) are the main treatments for reperfusion therapy. Erefore, timing is critical for intravenous thrombolytic therapy [5, 6]. Recombinant human prourokinase for injection (rhPro-UK) is a new generation of thrombolytic drugs and the precursor of urokinase, which can be gradually metabolized into urokinase to quickly dissolve thrombus and make blood vessels unobstructed [9, 10]. Is study used thrombolysis in myocardial infarction (TIMI) blood flow classification to evaluate the recanalization rate and compared the efficacy and safety of rhPro-UK and alteplase thrombolysis in STEMI patients. Recombinant human prourokinase for injection (rhPro-UK) is a new generation of thrombolytic drugs and the precursor of urokinase, which can be gradually metabolized into urokinase to quickly dissolve thrombus and make blood vessels unobstructed [9, 10]. is study used thrombolysis in myocardial infarction (TIMI) blood flow classification to evaluate the recanalization rate and compared the efficacy and safety of rhPro-UK and alteplase thrombolysis in STEMI patients. e detailed information is as follows
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