Prehospital Heparin Administration in Patients With STEMI Undergoing Primary PCI: HEPARIN STEMI Randomized Controlled Trial - PubMed

4 hours ago

Primary PCI is the recommended reperfusion method for ST-elevation myocardial infarction (STEMI) patients.
The HEPARIN STEMI trial assessed the benefits and safety of prehospital administration of unfractioned heparin (UFH) versus standard UFH at PCI time.
Patients received either a UFH bolus at first medical contact plus supplemental doses or standard UFH during PCI, aiming for activated clotting time ≥250 seconds.
The primary efficacy endpoint was TIMI 2-3 flow in the infarct-related artery (IRA) at initial angiography.
The primary safety endpoint was BARC 3-5 bleeding during hospital stay.
Results showed TIMI 2-3 flow in 43% of the pretreatment group versus 27% in the control group, a significant improvement.
No significant difference in major bleeding events was observed between groups.
Conclusion: Prehospital UFH pretreatment increased IRA patency by 16% without excessive bleeding in a mature STEMI network.

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