Table 1.

Summary of studies investigating intracoronary thrombolysis for patients with STEMI

Study	Year	No of patients (N)	Treatment arms	Route of delivery	Timing of delivery	P2Y12 inhibitor	GPIIb/IIIa inhibitor (%)	Unfractionated heparin	Thrombus aspiration (%)	Follow-up
Sezer et al 25	2009	95	Streptokinase 250 kU Nil	Guide catheter	Post-stent	Clopidogrel	100 100	100 U/kg	NR	6 months
Zhao et al 18	2015	183	Urokinase 50 000–100 000 000 U Stent implantation	Micro-catheter	Post-thrombus aspiration, pre-stent	Clopidogrel	NR	8000–9000 U (additional 1000 U every 1 hour as required)	NR	30 days
Greco et al 29	2013	102	Urokinase 200 000 U Thrombus aspiration only	Micro-catheter	Pre-stent	Clopidogrel	NR	100 U/kg	NR	6 months
Geng et al 20	2018	230	Prourokinase 10 mg Placebo	Punctured balloon catheter	Post-balloon, pre-stent	Ticagrelor	NR	3000 U+70 U/kg for PCI	NR	6 months
Xiao et al 28	2019	71	Prourokinase 10 mg Thrombus aspiration	Micro-catheter	Post-balloon, pre-stent	Ticagrelor	100 100	50–70 U/kg	0 100	12 months
Fu et al 19	2019	39	Prourokinase 10–20 mg Thrombus aspiration	Micro-catheter, child-in-mother catheter or pierced balloon	Pre-stent	Clopidogrel/ticagrelor	NR	NR	0 100	90 days
McCartney et al 24	2019	440	Alteplase 10 mg Alteplase 20 mg Placebo	Aspiration catheter or guide catheter if selectively engaged	Post-balloon, pre-stent	Clopidogrel/ticagrelor/prasugrel	21 16 10	10 000 U	32 30 27	3 months
Gibson et al 21	2020	36	Tenecteplase 4 mg Placebo	Balloon catheter	1st dose: pre-balloon; 2nd dose: post-stent	Clopidogrel	84 94	70 U/kg	NR	30 days
Wang et al 26	2020	182	Prourokinase 20 mg Placebo	Aspiration catheter	Post-thrombus aspiration, pre-stent	Ticagrelor	18 12	3000 U (additional dosage by ACT)	100 100	6 months
Wu et al 27	2020	50	Prourokinase 10 mg Placebo	Aspiration catheter	Post-thrombus aspiration, pre-stent	Ticagrelor	72 56	5000 U (additional dosage guided by ACT)	100 100	3 months
Huang et al 22	2021	345	Prourokinase 20 mg Tirofiban 10 µg/kg Placebo	Intracoronary catheter	Post-balloon or thrombus aspiration; pre-stent	Clopidogrel/ticagrelor	0 100 0	70–100 U/kg	52 50 50	30 days
Jiang et al 23	2021	260	Prourokinase 10 mg Placebo	Balloon catheter	Post-balloon, pre-stent	Ticagrelor	NR	100 U/kg	8 6	6 months

ACT, activated clotting time; GPIIb/IIIa, glycoprotein IIb/IIIa; NR, not reported; PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction.