Prehospital unfractionated heparin and primary percutaneous coronary intervention

Unfractionated heparin (UFH) is an anticoagulant used by some, but not all, ambulance services in the treatment of patients who will undergo primary percutaneous coronary intervention (PPCI) due to ST-elevation myocardial infarction (STEMI). This study reviews the effectiveness and safety of prehospital unfractionated heparin administration to STEMI patients prior to PPCI, and considers whether it should be used more widely for these purposes across international ambulance services. A literature search was conducted to identify articles relevant to prehospital UFH administration prior to PPCI. The reviewed literature unequivocally demonstrates that early anticoagulant administration is safe, effective and highly appropriate for STEMI patients who subsequently undergo PPCI. This study find that anticoagulants such as UFH or, in some jurisdictions, enoxaparin—should be strongly considered as a standard feature of prehospital treatment regimens for STEMI patients who will subsequently undergo PPCI.