Key result
Pretreatment with unfractionated heparin was associated with a reduction in coronary artery occlusion among patients with STEMI (RR 0.89; 95% CI 0.87-0.90; NNT 12).
Why the study?
Unfractionated heparin is frequently administered before PCI in STEMI, but whether pretreatment prior to catheterisation laboratory arrival affects coronary artery occlusion, mortality, and bleeding remains to be investigated.
Does pretreatment with unfractionated heparin reduce coronary artery occlusion, mortality, and major bleeding in patients with STEMI undergoing PCI?
Population
41,631 patients with a first STEMI undergoing PCI in Sweden
Comparison
UFH pretreatment prior to catheterisation laboratory arrival vs no pretreatment
Design
Registry-based observational cohort study
Follow-up
30 days
Authors
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Supports UFH pretreatment hypothesis in STEMI; leaves open randomized confirmation of occlusion reduction.
Cohort (n=41,631)
Yes
Does pretreatment with unfractionated heparin reduce coronary artery occlusion, mortality, and major bleeding in patients with STEMI undergoing PCI?
Relative Risk: 0.89 (95% CI 0.87–0.9)
Absolute Risk Reduction: 8.7%
Number Needed to Treat: 12
Pretreatment with unfractionated heparin before PCI in STEMI patients reduces coronary artery occlusion at presentation without increasing major in-hospital bleeding.
Emilsson et al. (2022) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=41,631). Unfractionated heparin (UFH) pretreatment vs. No pretreatment was evaluated on Coronary artery occlusion at presentation in the catheterisation laboratory (RR 0.89, 95% CI 0.87-0.90). Pretreatment with unfractionated heparin was associated with a reduction in coronary artery occlusion among patients with STEMI (RR 0.89; 95% CI 0.87-0.90; NNT 12).
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