Key result
Pre-hospital administration of clopidogrel, heparin, or a combination of both significantly reduced the risk of in-hospital death in patients with STEMI (OR 0.32).
Why the study?
Minimizing the time from symptom onset to treatment improves STEMI care, and early pre-hospital antiplatelet and anticoagulant pharmacotherapy may allow for early effectiveness.
Does pre-hospital administration of clopidogrel and unfractionated heparin reduce in-hospital death and improve left ventricular ejection fraction in patients with STEMI?
Population
573 patients hospitalized due to STEMI in one Krakow hospital
Comparison
Pre-hospital clopidogrel and/or anticoagulant medications vs no pre-hospital administration
Design
Retrospective study
Follow-up
Hospital discharge
Authors
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Prehospital second antiplatelet was associated with lower risk; leaves open whether routine early use improves STEMI outcomes.
Observational (n=573)
No
Does pre-hospital administration of clopidogrel and unfractionated heparin reduce in-hospital death and improve left ventricular ejection fraction in patients with STEMI?
Odds Ratio: 0.32 (95% CI 0.13–0.78)
Absolute Event Rate: 4.9% vs 8.3%
Pre-hospital administration of clopidogrel and unfractionated heparin in STEMI patients is associated with preserved left ventricular ejection fraction and reduced in-hospital mortality.
Żurowska-Wolak et al. (2021) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=573). Pre-hospital administration of clopidogrel and/or heparin vs. No pre-hospital administration of antiplatelet or anticoagulant medications was evaluated on In-hospital death (OR 0.32, 95% CI 0.13-0.78). Pre-hospital administration of clopidogrel, heparin, or a combination of both significantly reduced the risk of in-hospital death in patients with STEMI (OR 0.32).
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