Acute ST-segment elevation myocardial infarction
Conditions
Interventions
experimental group:intracoronary injection of the prourokinase and standard care
control group:none
Sponsors
Cangzhou Central Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. duration from onset of symptoms (typical ischaemic chest pain) to randomisation = 30 mins and >= 0.1 mV ST-segment elevation in >= 2 limb leads or >= 0.2 mV ST-segment elevation in >= 2 contiguous precordial leads; 2. aged 18–75 years; 3. Patients at risk of no reflow were selected if >= 1 of the following inclusion criteria should be met: 1) clinical history that included myocardial infarction, increased age (i.e., 65 years of age or older), duration of symptoms > 6h; 2) culprit coronary artery abnormalities including an occluded artery (Thrombolysis In Myocardial Infarction [TIMI] flow grade 0/1) at initial angiography, heavy thrombus burden (TIMI grade 2 or higher), long lesion length (>24 mm), small vessel diameter (i.e., 50%. 4. agree to enroll the trial and give the informed consent.
Exclusion criteria
Exclusion criteria: 1. presenting any of contraindication for fibrinolytic: 1) absolute: precious intracranial haemorrhage or stroke of unknown origin at anytime; ischaemic stroke in the preceding 6 months; central nervous system damage or neoplasms or arterioveous malformation; recent major trauma/surgery/head injury (within the preceding month); gastrointestinal bleeding within the past month; known bleeding disorder (excluding menses); aortic dissection; non-compressible punctures in the past 24 hours (e.g.liver biopsy,lumbar puncture); 2) relative: transient ischaemic attack in the preceding 6 months; oral anticoagulant therapy;pregnancy or within 1 week postpartum; refractory hypertension (SBP> 180 mmHg and/or DBP >110mmHg); advanced liver disease; infective endocarditis; active peptic ulcer; prolonged or traumatic resuscitation; 2. life expectancy<12 months; 3. a contraindication to magnetic resonance imaging (MRI) (e.g.some types of permanent pacemaker which can not use in MRI environment;ICD;claustrophobia;intracranial metal implants); 4. cardiogenic shock; 5. with history of old myocardial infarction.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Final MSI; | — |
Secondary
| Measure | Time frame |
|---|---|
| ST segment elevation resolution;All-cause mortality in hospital;Cardiac death in hospital;Re-infarction in hospital;Left ventricular end diastolic volume at early phase;Left ventricular end systolic volume at early phase;LVEF at early phase;Intramyocardial haemorrhage at early phase;Infartion size at early phase;Microvescular obstruction at early phase;Myocardium at risk at early phase;Myocardial salvage index at early phase;Regional left ventricular systolic wall stress at early phase;all-cause mortality 1 month after PPCI;Cardiac death 1 month after PPCI;Re-infarction 1 month after PPCI;Left ventricular end diastolic volume 1 month after PPCI;Left ventricular end systolic volume 1 month after PPCI;Left ventricular ejection fraction 1 month after PPCI;Intramyocardial haemorrhage 1 month after PPCI;Final infarction size 1 month after PPCI;Microvescular obstruction 1 month after PPCI;Final myocardium at risk 1 month after PPCI;Myocardial blush grade after PPCI;rate of no-reflow after PPCI; | — |
Countries
China
Contacts
Public ContactJun Zhang
Cangzhou Central Hospital
Outcome results
None listed