{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:37:51Z","timestamp":1788561471890,"version":"build-2803163510"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>It is uncertain whether adjunctive thrombolysis is beneficial for patients with ST-segment\u2013elevation myocardial infarction undergoing percutaneous coronary intervention (PCI) within 120 minutes of presentation. This study was to determine whether in patients presenting with ST-segment\u2013elevation myocardial infarction a single bolus recombinant staphylokinase (r-SAK) before timely PCI leads to improved patency of the infarct-related artery and reduces the infarct size.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This is an open-label, prospective, multicenter, randomized study. We enrolled patients aged 18 to 75 years who were within 12 hours of symptom onset of ST-segment\u2013elevation myocardial infarction and expected to undergo PCI within 120 minutes. Patients were administered loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive 5 mg bolus of r-SAK or normal saline intravenously before PCI. The primary end point was Thrombolysis in Myocardial Infarction flow grade 2 to 3 or grade 3 in the infarct-related artery 60 minutes after thrombolysis. The infarct size was detected by cardiac magnetic resonance 5 days after randomization. The safety end point was major bleeding (Bleeding Academic Research Consortium \u22653) during 30-day follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A total of 283 patients were screened from 8 centers and 200 were randomized (median age, 58.5 years; 14% female). The median symptom to thrombolysis time was 252.5 (interquartile range, 142.8\u2013423.8) minutes and thrombolysis to coronary arteriography was 50.0 (interquartile range, 37.0\u201366.0) 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%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) and Thrombolysis in Myocardial Infarction flow grade 3 (51.0% versus 18.0%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) and had smaller infarct size (21.91\u00b110.84% versus 26.85\u00b112.37%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.016). There was no increase in major bleeding (r-SAK, 1.0% versus control, 3.0%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.616).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>A single bolus r-SAK before primary PCI for ST-segment\u2013elevation myocardial infarction improves infarct-related artery patency and reduces infarct size without increasing major bleeding.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT05023681.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.123.013455","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T10:00:28Z","timestamp":1706004028000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Single Bolus r-SAK Before Primary PCI for ST-Segment\u2013Elevation Myocardial Infarction"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct05023681","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Pengsheng","family":"Chen","sequence":"first","affiliation":[{"name":"Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China."},{"name":"Department of Cardiology, Xuzhou Central Hospital, Jiangsu, China (P.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4126-1285","authenticated-orcid":true,"given":"John W.","family":"Eikelboom","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University or Thrombosis Service, Hamilton General Hospital, ON, Canada (J.W.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyue","family":"Tan","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4491-0554","authenticated-orcid":true,"given":"Wenhao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1235-3068","authenticated-orcid":true,"given":"Yi","family":"Xu","sequence":"additional","affiliation":[{"name":"Radiology (Y.X., J.W., X. Zhu), the First Affiliated Hospital of Nanjing Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianling","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Nanjing Medical University, Jiangsu, China (J.B., H.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Radiology (Y.X., J.W., X. Zhu), the First Affiliated Hospital of Nanjing Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China."},{"name":"Department of Cardiology, the First People\u2019s Hospital of Yancheng, Jiangsu, China (T.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3007-0387","authenticated-orcid":true,"given":"Xiaoxuan","family":"Gong","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Liu","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China."},{"name":"Department of Cardiology, the First People\u2019s Hospital of Lianyungang, Jiangsu, China (K.L., B.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the Affiliated Changzhou No. 2 People\u2019s Hospital of Nanjing Medical University, Jiangsu, China (X.C., Z.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China (X.W., B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6804-5235","authenticated-orcid":true,"given":"Li","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Taizhou People\u2019s Hospital, Jiangsu, China (L.Z., G.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the Second Hospital of Dalian Medical University, Liaoning, China (X. Zhao, C. Lu)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naiquan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Huai\u2019an Second People\u2019s Hospital Affiliated to Xuzhou Medical University, Jiangsu, China (N.Y., L.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6926-9516","authenticated-orcid":true,"given":"Jun","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, China (J.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2240-5108","authenticated-orcid":true,"given":"Jun","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, China (J.P., M.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First People\u2019s Hospital of Lianyungang, Jiangsu, China (K.L., B.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0895-3215","authenticated-orcid":true,"given":"Zengguang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the Affiliated Changzhou No. 2 People\u2019s Hospital of Nanjing Medical University, Jiangsu, China (X.C., Z.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baihong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China (X.W., B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1343-1187","authenticated-orcid":true,"given":"Guoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Taizhou People\u2019s Hospital, Jiangsu, China (L.Z., G.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2272-7097","authenticated-orcid":true,"given":"Chuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the Second Hospital of Dalian Medical University, Liaoning, China (X. 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