Abstract: Abstract: Objective To evaluate the effect of thrombus aspiration combined with intracoronary recombinant human pro-urokinase (rhpro-UK) preconditioning on coronary blood flow and myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI) and high thrombus burden. Methods A total of 120 STEMI patients with high thrombus burden treated with primary PCI were collected in this study. Patients were randomly divided into two groups: thrombus aspiration combined with intracoronary rhpro-UK group (n=60) and thrombus aspiration control group (n=60). The coronary blood flow, myocardial perfusion, major adverse cardiovascular events and incidence of hemorrhage were compared between the two groups. Results TIMI blood flow grade, myocardial blush grade and ST segment fall rate (≥50%) were all higher in the thrombus aspiration combined with intracoronary rhpro-UK group than those in the control group.After PCI, incidence rates of cTFCand NRP were significantly diseased (P＜0.05). There were no significant differences in stroke, major adverse cardiovascular events and bleeding within 30 days after operation between the two groups (P＞0.05). Conclusion Thrombus aspiration combined with intracoronary rhpro-UK preconditioning can improve the coronary blood flow and myocardial perfusion in primary PCI of STEMI patients with high thrombus burden.

Key words: ST elevation myocardial infarction, percutaneous coronary intervention, thrombus aspiration, rhpro-UK,
high thrombus burden, preconditioning