Coronary disease & ACSRandomised controlled trial
Heparin administration at first medical contact vs immediately before primary percutaneous coronary intervention: the HELP-PCI trial
- Randomised controlled trial
- investigator-initiated
- multicentre (36 centres, China)
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
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