Objective  To investigate the clinical value of intracoronary injection of recombinant human prourokinase for injection in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI).

Methods  Retrospective analysis was used to collect STEMI patients who underwent emergency PCI in department of cardiology from January to December 2019. According to the targeted injection of drugs through a guided catheter by intraoperative patients before stent implantation, the patients were divided into a tirofiban group (70 cases) and a recombinant human urokinase group (70 cases). TIMI blood flow grade, ST segment fall value (STR) of infarct-related artery, plasma D-dimer, left ventricular ejection fraction (LVEF) and coronary microcirculation dysfunction were compared between the two groups. At the same time, the general information of the patients, major adverse cardiovascular events (MACE) and bleeding were recorded.

Results  Compared with the tirofiban group, the TIMI blood flow level, LVEF, plasma D-dimer, and the proportion of the patients with STR≥70% in the recombinant human prourokinase group were significantly increased, while the incidence of slow flow/no reflow and MACE were significantly reduced , and the differences between the two groups were statistically significant (P<0.05) .The incidence of bleeding events in the recombinant human prourokinase group showed a downward trend, but there was no significant difference between the two groups(P>0.05).

Conclusion  Intracoronary injection of recombinant human prourokinase through the guiding catheter can significantly improve myocardial perfusion and prognosis in patients with STEMI. It also reduces adverse cardiovascular events and has a high safety margin, which is worth promoting in the clinic.

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