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Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI.

Authors :
Bataila, Vlad
Popa-Fotea, Nicoleta-Monica
Cojocaru, Cosmin
Calmac, Lucian
Mihai, Cosmin
Dragoescu, Marian-Bogdan
Ploscaru, Vlad
Marinescu, Mugur
Iliese, Vasile
Avram, Anamaria-Georgiana
Mitran, Raluca-Elena
Vatasescu, Radu-Gabriel
Source :
Journal of Clinical Medicine. Mar2024, Vol. 13 Issue 6, p1710. 8p.
Publication Year :
2024

Abstract

(1) Background: Acute ST-segment elevation myocardial infarction (STEMI) remains one of the main morbidity and mortality contributors worldwide. Its main treatment, primary percutaneous coronary intervention (pPCI), can only be performed with a high anticoagulation regimen, usually with heparin. There is still not enough evidence regarding the timing of heparin administration. (2) Methods: We conducted a multicenter observational study of 614 consecutive STEMI patients treated between 2017 and 2019. We split the population in two groups: one that received heparin at the first medical contact, as early as possible, and the second group that received heparin at the PCI capable center or in the cath lab. (3) Results: There was a significantly higher rate of infarct-related artery (IRA) patency at the time of the coronary angiogram in the pre-transfer heparin group than in the on-site heparin group, 44.7% vs. 37.3%, p = 0.042. Also, the early heparin group received shorter and wider stents. There was no difference in bleeding rates or in the in-hospital and two-year mortality rates. (4) Conclusions: Early administration of heparin leads to a higher rate of reperfusion in the IRA, before pPCI, with significant related benefits, such as better stent implantation parameters, without increased bleeding rates. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20770383
Volume :
13
Issue :
6
Database :
Academic Search Index
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
176336263
Full Text :
https://doi.org/10.3390/jcm13061710