Coronary disease & ACS

Heparin administration at first medical contact vs immediately before primary percutaneous coronary intervention: the HELP-PCI trial

Eur Heart JPublished Randomised controlled trial

Primary resultResult — go to the resultOdds ratio 1.44 95% CI 1.06–1.97

Authors' conclusion

Pre-treatment with loading-dose UFH at FMC was associated with an improvement of spontaneous reperfusion of IRA without increasing the risk of major bleeding.

Study context

Population
Patients with ST-elevation myocardial infarction (STEMI) presenting ≤12 h after symptom onset undergoing primary PCI
Participants
999 patients
Comparison
Unfractionated heparin (UFH) at first medical contact vs UFH in the Cath Lab before primary PCI
  • First medical contact (FMC)n = 505
  • Cath Labn = 494reference
Primary endpoint
TIMI flow grade 3 of the infarct-related artery at diagnostic angiography before primary PCI
Methodological detailsinvestigator-initiated, multicentre (36 centres, China)
  • Investigator-initiated
  • Multicentre (36 centres, China)

Primary result

As reported in the abstract

Odds ratio

1.44

95% CI 1.06–1.97

P = 0.02

By group

FMC vs Cath Lab
OR 1.44 (95% CI 1.06–1.97); P = 0.02

Secondary outcomes

12-month major adverse cardiac and cerebrovascular events (MACCE); complete epicardial and myocardial reperfusion after PCI

No significant differences in secondary endpoints

Safety

30-day Bleeding Academic Research Consortium (BARC) type ≥2 bleeding

No significant difference in the safety endpoint (major bleeding)

Original publication

Heparin administration at first medical contact vs immediately before primary percutaneous coronary intervention: the HELP-PCI trial. Eur Heart J. Published 1 August 2025. doi:10.1093/eurheartj/ehaf481

Summarised from the published abstract; every number is checked against it

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