PMID- 36066155
OWN - NLM
STAT- MEDLINE
DCOM- 20220908
LR  - 20221214
IS  - 2284-0729 (Electronic)
IS  - 1128-3602 (Linking)
VI  - 26
IP  - 16
DP  - 2022 Aug
TI  - Efficacy and safety of intracoronary pro-urokinase injection during percutaneous 
      coronary intervention in treating ST elevation myocardial infarction patients: a 
      systematic review and meta-analysis of randomized controlled trials.
PG  - 5802-5813
LID - 29518 [pii]
LID - 10.26355/eurrev_202208_29518 [doi]
AB  - OBJECTIVE: Intracoronary injection of pro-urokinase (Pro-UK) during percutaneous 
      coronary intervention (PCI) seems to be a promising treatment in improving 
      myocardial perfusion. In this systematic review and meta-analysis, we aimed at 
      investigating the efficacy and safety of intracoronary Pro-UK injection during 
      PCI in ST elevation myocardial infarction (STEMI) patients. MATERIALS AND 
      METHODS: A comprehensive literature searched on PubMed, Embase, Cochrane, 
      Ovid-MEDLINE, Ovid-Embase, Ovid-Cochrane Databases and ClinicalTrials.gov from 
      inception until June 1, 2022, in English only. The primary outcome was myocardial 
      perfusion, including thrombolysis in myocardial infarction (TIMI) grades, 
      corrected TIMI frame count (CTFC), TIMI myocardial perfusion grades (TMPG). The 
      secondary outcomes were ST-segment resolution (STR), major adverse cardiovascular 
      events (MACE), myocardial marker, cardiac function and hemorrhagic complications. 
      RESULTS: We identified 5 studies (all RCTs) involving 761 participants. Under PCI 
      procedure, compared with placebo, intracoronary Pro-UK injection may improve 
      myocardial perfusion, including increasing the TIMI grades [odd ratio (OR) 0.46; 
      95% confidence interval (CI) 0.28-0.75; p = 0.002; I2 = 0%] , CTFC (OR -3.47; 95% 
      CI [-5.60, -1.33]; p = 0.001; I2 = 0%) and TMPG (OR 0.17; 95% CI [0.06-0.44]; p = 
      0.0003; I2 = 0%), increase the rate of STR (OR 2.25; 95% CI [1.56-3.26]; p < 
      0.0001; I2 = 0%), reduce the incidence of MACE (OR 0.51; 95% CI [0.33-0.81]; p = 
      0.004; I2 = 0%) and reduce myocardial infarct size (CK, standardized mean 
      difference [SMD] -0.45; 95% [CI] [-0.62, -0.28]; p < 0.00001; I2 = 10%. CK-MB, 
      [SMD] -0.43; 95% CI [-0.68, -0.18]; p = 0.0007; I2 = 60%. cTnI, [SMD] -0.31; 95% 
      CI [-0.46, -0.17]; p < 0.0001; I2 = 0%). Moreover, the treatment may improve the 
      cardiac functions (LVFE, pooled mean difference [MD] 1.23; 95% CI [0.66-1.79]; p 
      < 0.0001; I2 = 24%. LVEDd, pooled MD -0.13; 95% CI [-0.17, -0.09]; p < 0.00001; 
      I2 = 0%). But there is no statistically significant difference between the Pro-UK 
      group and placebo in the occurrence of hemorrhagic complications (OR 1.19; 95% CI 
      [0.75-1.87]; p = 0.46; I2 = 0%). CONCLUSIONS: Intracoronary Pro-UK injection 
      during PCI in STEMI patients is an effective and safe treatment to perform. The 
      treatment may improve myocardial perfusion and rate of STR, as well as decreasing 
      the incidence of MACE and myocardial infarct size. Importantly, the treatment may 
      improve the cardiac functions and life quality. In the future, more 
      multi-centered and massive sample studies are required.
FAU - Yin, X-S
AU  - Yin XS
AD  - Department of Immunology, Department of Neurosurgery, Mianyang Central Hospital, 
      School of Medicine, University of Electronic Science and Technology of China, 
      Mianyang, Sichuan, People's Republic of China. yangjing6525@163.com.
FAU - Huang, Y-W
AU  - Huang YW
FAU - Li, Z-P
AU  - Li ZP
FAU - Dong, J-L
AU  - Dong JL
FAU - Zou, J-M
AU  - Zou JM
FAU - Tian, L
AU  - Tian L
FAU - Yang, J
AU  - Yang J
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - Italy
TA  - Eur Rev Med Pharmacol Sci
JT  - European review for medical and pharmacological sciences
JID - 9717360
RN  - 0 (Recombinant Proteins)
RN  - EC 3.4.21.73 (Urokinase-Type Plasminogen Activator)
RN  - U5NH2JV64T (saruplase)
SB  - IM
MH  - Humans
MH  - *Myocardial Infarction/drug therapy
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Recombinant Proteins
MH  - *ST Elevation Myocardial Infarction/etiology/therapy
MH  - Treatment Outcome
MH  - Urokinase-Type Plasminogen Activator
EDAT- 2022/09/07 06:00
MHDA- 2022/09/09 06:00
CRDT- 2022/09/06 08:32
PHST- 2022/09/06 08:32 [entrez]
PHST- 2022/09/07 06:00 [pubmed]
PHST- 2022/09/09 06:00 [medline]
AID - 29518 [pii]
AID - 10.26355/eurrev_202208_29518 [doi]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2022 Aug;26(16):5802-5813. doi: 
      10.26355/eurrev_202208_29518.