Open Access

Safety and efficacy of intracoronary recombinant human prourokinase administration in patients with acute myocardial infarction and ST‑segment elevation: A meta‑analysis of randomized controlled trials

  • Authors:
    • Gang Fan
    • Xiang-Ge Wu
    • Wen-Ping Jiao
    • Hong-Kao Zhang
    • Dian-Long Guo
  • View Affiliations

  • Published online on: November 30, 2022     https://doi.org/10.3892/etm.2022.11739
  • Article Number: 40
  • Copyright: © Fan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Slow blood flow or no reflow following percutaneous coronary intervention (PCI) in patients with acute ST‑segment elevation myocardial infarction (STEMI) typically leads to an adverse prognosis. However, it is controversial whether to use prourokinase (Pro‑UK) during PCI in patients with acute STEMI. The present meta‑analysis compared the efficacy and safety of intracoronary Pro‑UK administration in patients with acute STEMI. Published randomized controlled trials (RCTs) were analyzed to compare Pro‑UK with non‑Pro‑UK treatment in patients with acute STEMI. PubMed, Cochrane Library and China National Knowledge Infrastructure were searched and meta‑analysis was performed using Review Manager 5.3 software. A total of 13 RCTs were selected and 1,797 patients were considered in the meta‑analysis, including 897 patients who received Pro‑UK intervention and 900 patients who were in the control group. No significant heterogeneity was identified across these selected studies. Pro‑UK therapy significantly decreased the incidence of major adverse cardiac events [risk ratio (RR), 0.68; 95% CI, 0.56‑0.82, P<0.0001], left ventricular end‑diastolic diameter [standardized mean difference (SMD), ‑0.26; 95% CI, ‑0.40 – ‑0.12; P=0.0003], corrected thrombolysis in myocardial infarction (TIMI) frame count [SMD, ‑0.45; 95% CI, ‑0.62 – ‑0.28; P<0.00001] and cardiac troponin I [SMD, ‑0.31; 95% CI, ‑0.46 – ‑0.17; P<0.0001]. In addition, Pro‑UK administration increased TIMI grade 3 flow (RR, 1.16; 95% CI, 1.07‑1.25; P=0.0003), TIMI myocardial perfusion grade 3 (RR: 1.39, 95% CI: 1.12‑1.74, P=0.004), ST‑segment resolution (RR, 1.23; 95% CI, 1.10‑1.36; P=0.0002) and left ventricular ejection fraction (SMD, 0.38; 95% CI, 0.27‑0.49; P<0.00001). No significant difference was identified in bleeding (RR, 1.12; 95% CI, 0.85‑1.47; P=0.41). The present meta‑analysis determined that intracoronary Pro‑UK administration is efficacious and safe to decrease slow blood flow or no reflow phenomena following PCI and improve the prognosis of patients with acute STEMI.
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Spandidos Publications style
Fan G, Wu X, Jiao W, Zhang H and Guo D: Safety and efficacy of intracoronary recombinant human prourokinase administration in patients with acute myocardial infarction and ST‑segment elevation: A meta‑analysis of randomized controlled trials. Exp Ther Med 25: 40, 2023.
APA
Fan, G., Wu, X., Jiao, W., Zhang, H., & Guo, D. (2023). Safety and efficacy of intracoronary recombinant human prourokinase administration in patients with acute myocardial infarction and ST‑segment elevation: A meta‑analysis of randomized controlled trials. Experimental and Therapeutic Medicine, 25, 40. https://doi.org/10.3892/etm.2022.11739
MLA
Fan, G., Wu, X., Jiao, W., Zhang, H., Guo, D."Safety and efficacy of intracoronary recombinant human prourokinase administration in patients with acute myocardial infarction and ST‑segment elevation: A meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 25.1 (2023): 40.
Chicago
Fan, G., Wu, X., Jiao, W., Zhang, H., Guo, D."Safety and efficacy of intracoronary recombinant human prourokinase administration in patients with acute myocardial infarction and ST‑segment elevation: A meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 25, no. 1 (2023): 40. https://doi.org/10.3892/etm.2022.11739