Single Bolus r-SAK Before Primary PCI for ST-Segment–Elevation Myocardial Infarction

• DOI: 10.1161/circinterventions.123.013455
• Publication Date: 2024-01-23T10:00:28Z
• Authors: Pengsheng Chen; John W. Eikelboom; Chunyue Tan; Wenhao Zhang; Yi Xu; Jianling Bai; Jun Wang; Tong Wang; Xiaoxuan Gong; Kun Liu; Xin Chen; Xiaoyan Wang; Li Zhu; Xin Zhao; Naiquan Yang; Jun Jiang; Jun Pu; Bo Zhao; Zengguang Chen; Baihong Li; Guoyu Wang; Chuan Lu; Lianghong Ying; Meng Jiang; Xiaomei Zhu; Jiazheng Ma; Zhou Dong; Chen Li; Jiaxin Zong; Fumin Zhang; Jun Zhu; Jun Huang; Xiangqing Kong; Hao Yu; Chunjian Li
• Keywords: Interquartile range; TIMI; Bolus (digestion); Clinical endpoint

It is uncertain whether adjunctive thrombolysis beneficial for patients with ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention (PCI) within 120 minutes of presentation. This study was to determine in presenting a single bolus recombinant staphylokinase (r-SAK) before timely PCI leads improved patency the infarct-related artery and reduces infarct size. an open-label, prospective, multicenter, randomized study. We enrolled aged 18 75 years who were 12 hours symptom onset expected undergo minutes. Patients administered loading doses aspirin ticagrelor intravenous heparin receive 5 mg r-SAK or normal saline intravenously PCI. The primary end point Thrombolysis Myocardial Infarction flow grade 2 3 60 after thrombolysis. size detected by cardiac magnetic resonance days randomization. safety major bleeding (Bleeding Academic Research Consortium ≥3) during 30-day follow-up. A total 283 screened from 8 centers 200 (median age, 58.5 years; 14% female). median time 252.5 (interquartile range, 142.8-423.8) arteriography 50.0 37.0-66.0) compared more often had (69.0% versus 29.0%; P<0.001) (51.0% 18.0%; smaller (21.91±10.84% 26.85±12.37%; P=0.016). There no increase (r-SAK, 1.0% control, 3.0%; P=0.616). improves without increasing bleeding. URL: https://www.clinicaltrials.gov; Unique identifier: NCT05023681.