Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI
(1) <b>Background</b>: 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, usuall...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/6/1710 |
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| author | Vlad Bataila Nicoleta-Monica Popa-Fotea Cosmin Cojocaru Lucian Calmac Cosmin Mihai Marian-Bogdan Dragoescu Vlad Ploscaru Mugur Marinescu Vasile Iliese Anamaria-Georgiana Avram Raluca-Elena Mitran Radu-Gabriel Vatasescu |
| author_facet | Vlad Bataila Nicoleta-Monica Popa-Fotea Cosmin Cojocaru Lucian Calmac Cosmin Mihai Marian-Bogdan Dragoescu Vlad Ploscaru Mugur Marinescu Vasile Iliese Anamaria-Georgiana Avram Raluca-Elena Mitran Radu-Gabriel Vatasescu |
| author_sort | Vlad Bataila |
| collection | DOAJ |
| description | (1) <b>Background</b>: 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) <b>Methods</b>: 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) <b>Results</b>: 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%, <i>p</i> = 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) <b>Conclusions</b>: 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. |
| first_indexed | 2024-04-24T18:08:44Z |
| format | Article |
| id | doaj.art-0227d32360b2470b9bfde4e9a7513756 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T18:08:44Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-0227d32360b2470b9bfde4e9a75137562024-03-27T13:48:06ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01136171010.3390/jcm13061710Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMIVlad Bataila0Nicoleta-Monica Popa-Fotea1Cosmin Cojocaru2Lucian Calmac3Cosmin Mihai4Marian-Bogdan Dragoescu5Vlad Ploscaru6Mugur Marinescu7Vasile Iliese8Anamaria-Georgiana Avram9Raluca-Elena Mitran10Radu-Gabriel Vatasescu11Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaLaboratory of Interventional Cardiology, Carol Davila Central Military Universitary Emergency Hospital, Mircea Vulcanescu Str. 88, 010825 Bucharest, RomaniaDepartment of Cardiology, Bagdasar-Arseni Emergency Clinical Hospital, Soseaua Berceni 12, 041915 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, RomaniaDepartment of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania(1) <b>Background</b>: 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) <b>Methods</b>: 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) <b>Results</b>: 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%, <i>p</i> = 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) <b>Conclusions</b>: 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.https://www.mdpi.com/2077-0383/13/6/1710ST-elevation myocardial infarctionpercutaneous coronary interventionheparininfarct-related artery patencybleeding ratesreperfusion |
| spellingShingle | Vlad Bataila Nicoleta-Monica Popa-Fotea Cosmin Cojocaru Lucian Calmac Cosmin Mihai Marian-Bogdan Dragoescu Vlad Ploscaru Mugur Marinescu Vasile Iliese Anamaria-Georgiana Avram Raluca-Elena Mitran Radu-Gabriel Vatasescu Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI Journal of Clinical Medicine ST-elevation myocardial infarction percutaneous coronary intervention heparin infarct-related artery patency bleeding rates reperfusion |
| title | Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI |
| title_full | Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI |
| title_fullStr | Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI |
| title_full_unstemmed | Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI |
| title_short | Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI |
| title_sort | parenteral anticoagulation at first medical contact improves infarct related artery patency in stemi |
| topic | ST-elevation myocardial infarction percutaneous coronary intervention heparin infarct-related artery patency bleeding rates reperfusion |
| url | https://www.mdpi.com/2077-0383/13/6/1710 |
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