PMID- 32472307
OWN - NLM
STAT- MEDLINE
DCOM- 20211018
LR  - 20211018
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 51
IP  - 1
DP  - 2021 Jan
TI  - Long-term outcome of patients with ST-segment elevation myocardial infarction 
      treated with low-dose intracoronary thrombolysis during primary percutaneous 
      coronary intervention: the 5-year results of the DISSOLUTION Trial.
PG  - 212-216
LID - 10.1007/s11239-020-02157-w [doi]
AB  - We tested the hypothesis that adjunctive thrombolysis at time of primary 
      percutaneous coronary intervention (PCI) may affect favourably the long-term 
      outcome of patients with ST elevation myocardial infarction (STEMI). To this end, 
      we undertook a substudy of the DISSOLUTION (Delivery of thrombolytIcs before 
      thrombectomy in patientS with ST-segment elevatiOn myocardiaL infarction 
      Undergoing primary percuTaneous coronary interventION) trial. A total of 95 
      patients were randomized to local delivery of urokinase (n = 48) or placebo 
      (n = 47). After PCI, a greater proportion of patients receiving urokinase had an 
      improvement in myocardial perfusion, as indicated by a significantly higher final 
      Thrombolysis in myocardial infarction (TIMI) grade 3, myocardial blush grade, and 
      60-min ST-segment resolution > 70%, as well as lower corrected TIMI frame count. 
      At 1-year echocardiography, urokinase-treated patients exhibited significantly 
      lower LV dimension, as well as higher LV ejection fraction and wall motion score 
      index as compared with placebo-treated patients. At 5 years, major acute 
      cardiovascular events (MACEs) were significantly less common in the urokinase 
      group (P = 0.023), mainly due to a lower occurrence of hospitalisation for heart 
      failure (P = 0.038). Multivariate analysis showed that factors independently 
      associated with 5-year occurrence of MACEs were LV remodelling at 1-year 
      echocardiography (P = 0.0001), 1-year LV ejection fraction (P = 0.0001), TIMI 
      grade flow 0-2 (P = 0.0019), and age at time of PCI (P = 0.0173). In conclusion, 
      low-dose intracoronary urokinase during primary PCI is associated with a more 
      favourable 5-year outcome of patients with STEMI.
FAU - Pelliccia, Francesco
AU  - Pelliccia F
AUID- ORCID: 0000-0003-1260-1308
AD  - Department of Cardiovascular Sciences, Sapienza University, Rome, Italy. 
      f.pelliccia@mclink.it.
AD  - Department 'Attilio Reale', Sapienza University, Via del Policlinico 155, 00161, 
      Rome, Italy. f.pelliccia@mclink.it.
FAU - Greco, Cesare
AU  - Greco C
AD  - Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
FAU - Tanzilli, Gaetano
AU  - Tanzilli G
AD  - Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
FAU - Viceconte, Nicola
AU  - Viceconte N
AD  - Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
FAU - Schiariti, Michele
AU  - Schiariti M
AD  - Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
FAU - Gaudio, Carlo
AU  - Gaudio C
AD  - Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Fibrinolytic Agents)
RN  - EC 3.4.21.73 (Urokinase-Type Plasminogen Activator)
SB  - IM
MH  - Aged
MH  - Female
MH  - Fibrinolytic Agents/administration & dosage/*therapeutic use
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Prospective Studies
MH  - ST Elevation Myocardial Infarction/*therapy
MH  - *Thrombolytic Therapy
MH  - Treatment Outcome
MH  - Urokinase-Type Plasminogen Activator/administration & dosage/*therapeutic use
OTO - NOTNLM
OT  - Left ventricular remodelling
OT  - Myocardial infarction
OT  - Outcome
OT  - Prognosis
OT  - Thrombolysis
OT  - Urokinase
EDAT- 2020/05/31 06:00
MHDA- 2021/10/21 06:00
CRDT- 2020/05/31 06:00
PHST- 2020/05/31 06:00 [pubmed]
PHST- 2021/10/21 06:00 [medline]
PHST- 2020/05/31 06:00 [entrez]
AID - 10.1007/s11239-020-02157-w [pii]
AID - 10.1007/s11239-020-02157-w [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2021 Jan;51(1):212-216. doi: 10.1007/s11239-020-02157-w.