Coronary disease & ACSRandomised controlled trial
Prehospital Heparin Administration in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention (PCI): HEPARIN-STEMI Randomized Controlled Trial
- Randomised controlled trial
- single-centre
- open-label
- Randomized March 2022 to February 2025
Authors' conclusion
In patients with STEMI undergoing primary PCI, in a mature STEMI network, pretreatment with UFH at first prehospital medical contact was associated with an absolute 16% increase in infarct-related artery patency without an increased risk of bleeding.
Study context
- Population
- Patients with STEMI with ≤6 hours symptom duration referred to primary PCI
- Participants
- 298 vs 295
- Comparison
- Prehospital unfractionated heparin (UFH) pretreatment vs standard UFH at PCI
- UFH pretreatmentn = 298
- Controln = 295reference
- Primary endpoint
- TIMI flow grade 2-3 in the infarct-related artery (efficacy); BARC type 3-5 bleeding (safety)
- Follow-up
- Initial coronary angiography (efficacy); index hospital stay (safety)
Primary result
As reported in the abstract
TIMI flow grade 2-3 in the infarct-related artery · initial coronary angiography
Relative risk
1.59
95% CI 1.27–1.98
P < 0.001
By group
UFH pretreatment vs Control
RR 1.59 (95% CI 1.27–1.98); P < 0.001
Safety
| Outcome | UFH pretreatment | Control | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| BARC type 3-5 bleeding (primary safety end point) · index hospital stay | 2.4% | 2.0% | 1.16 (0.39–3.45) | P = 0.789 | |
| 0.20.5125Relative risk (log scale) |
Original publication
Prehospital Heparin Administration in Patients With STEMI Undergoing Primary PCI: HEPARIN-STEMI Randomized Controlled Trial. Circulation. Published 30 March 2026. doi:10.1161/circulationaha.126.079839
Summarised from the published abstract; every number is checked against it