The Efficacy Of Recombinant Human Pro-Urokinase In Patients With Acute Myocardial Infarction

Aim:To investigate the efficacy of recombinant human pro-urokinase in patients with acute myocardial infarction with ST-segment elevation.Methods:A total of 100 patients with acute myocardial infarction with ST-segment elevation were enrolled in the department of Cardiology of Xintai city people's hospital.These patients were randomly assigned to receive thrombolytic therapy with pro-urokinase(experiment group,n = 50)or urokinase(control group,n=50).The recanalization rate at different time points,peak value of serum cardiac enzymes,time to peak,complications,bleeding rates and mortality during hospitalization were analyzed and compared between two groups.Results:1.No significant differences were observed in age,sex,risk factors(including hypertension,diabetes,hyperlipemia,smoking and obesity),heart function on admission,time from symptom onset to thrombolysis between the two groups.2.The recanalization rates at 30 min,60 min,90 min and 120 min were 10.00%,52.00%,80.00%and 84.00%,respectively,in the pro-urokinase group;while the corresponding recanalization rates in the urokinase group were 8.00%,30.00%,60.00%and 62.00%,respectively.The recanalization rate at the same time point was significantly higher in the pro-urokinase group than that in the urokinase group(P<0.05).3.The rate of recanalization of the infarct-related artery was significantly higher in the pro-urokinase group than that in the urokinase group(70.00%vs 58.00%,P<0.05).4.The left ventricular ejection fraction(LVEF)in the pro-urokinase group was significantly higher than that in the urokinase group(55.95 ± 10.23%vs 51.25±11.77%,P<0.05).5.The peak levels of serum creatine kinase isoenzyme MB(CKMB)and cardiac troponin I(cTnl)in the pro-urokinase group were significantly lower than those in the urokinase group(CKMB 133.00±178.00 vs 160.00 ± 132.00 U/L;cTnl 12.50 ± 10.26 VS 16.66 ± 10.30 ng/mL,P<0.05).Moreover,the time to peak for CKMB in the pro-urokinase group was significantly shorter than that in the urokinase group(8.2 ±4.50 vs 11.5 ± 15 h,P<0.05).6.Compared with urokinase,pro-urokinase can significantly reduce the incidences of ventricular aneurysm,serious cardiac arrhythmias,heart failure,postinfarction angina pectoris and vascular reocclusion(P<0.05).However,no significant difference was observed in the incidence of hydropericardium between the two groups(P>0.05).7.Gastrointestinal bleeding,cerebral hemorrhage and gingival hemorrhage occurred in 4,1 and 2 patients,respectively in the urokinase group.Only one with gastrointestinal bleeding and one with gingival hemorrhage were observed in the pro-urokinase group.The overall bleeding rate in the pro-urokinase group was significantly lower than that in the urokinase group(4.00%vs 14.00%,P<0.05).8.There was no significant difference in mortality rate during hospitalization between the pro-urokinase group and the urokinase group(2.00%vs 4.00%,P>0.05).Conclusions:Compared with urokinase,thrombolytic therapy with pro-urokinase resulted in a higher recanalization rate and lower rates of complications,deaths and bleeding in patients with acute myocardial infarction with ST-segment elevation.Pro-urokinase is a relatively safe drug for the treatment of acute myocardial infarction with ST-segment elevation.