Thrombolytic therapy before percutaneous coronary intervention improves short-term cardiac function evaluated by cardiac magnetic resonance for ST-segment elevation myocardial infarction.

This article investigates the efficacy of administering a single bolus of half-dose recombinant staphylokinase (r-SAK) before percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). In a randomized controlled trial involving 64 STEMI patients, those receiving r-SAK prior to PCI showed significantly improved short-term cardiac function, evidenced by higher left ventricular ejection fraction and cardiac output index, without increased incidence of microvascular obstruction (MVO) or intramyocardial hemorrhage (IMH), as assessed by cardiac magnetic resonance imaging. Segmental myocardial strain analysis further demonstrated better longitudinal and circumferential strain in the r-SAK group across infarcted and non-infarcted myocardial segments. These findings suggest that pre-PCI thrombolytic therapy with half-dose r-SAK may enhance myocardial recovery in STEMI patients expected to undergo PCI within 120 minutes of presentation.