Single bolus recombinant staphylokinase beneficial for STEMI patients undergoing PCI: Circulation

The study's primary endpoint was Thrombolysis in Myocardial Infarction flow grade 2 to 3 or grade 3 in the infarct-related artery 60 minutes after thrombolysis. Cardiac magnetic resonance was used to detect infarct size five days after randomization. During the 30-day follow-up, the safety endpoint was major bleeding (Bleeding Academic Research Consortium ≥3).

283 patients were screened from 8 centres, and 200 were randomized (median age, 58.5 years; 14% female).

Based on the study, the researchers reported the following findings:

• The median symptom to thrombolysis time was 252.5 minutes and thrombolysis to coronary arteriography was 50.0 minutes.
• Patients randomized to r-SAK compared with normal saline more often had Thrombolysis in Myocardial Infarction flow grade 2 to 3 (69.0% versus 29.0%) and Thrombolysis in Myocardial Infarction flow grade 3 (51.0% versus 18.0%) and had smaller infarct size (21.91±10.84% versus 26.85±12.37%).
• There was no increase in major bleeding (r-SAK, 1.0% versus control, 3.0%).

"A single bolus r-SAK before primary PCI for ST-segment–-elevation myocardial infarction reduces infarct size and improves infarct-related artery patency without increasing major bleeding," the researchers concluded.

Reference:

The study titled, "Single Bolus r-SAK Before Primary PCI for ST-Segment–Elevation Myocardial Infarction," was published online in Circulation: Cardiovascular Interventions. DOI: https://doi.org/10.1161/CIRCINTERVENTIONS.123.013455