Editor’s Choice- Heparin pre-treatment in patients with ST-segment elevation myocardial infarction and the risk of intracoronary thrombus and total vessel occlusion. Insights from the TASTE trial
Key result
Heparin pre-treatment in STEMI patients was associated with a reduced risk of intracoronary thrombus (OR 0.73; 95% CI 0.65-0.83) and total vessel occlusion (OR 0.64; 95% CI 0.56-0.73) prior to PCI.
Why the study?
Does pre-treatment with unfractionated heparin reduce the risk of intracoronary thrombus and total vessel occlusion in patients with STEMI prior to percutaneous coronary intervention?
Population
7,144 patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention
Comparison
Pre-treatment with unfractionated heparin vs No heparin pre-treatment
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
Heparin pre-treatment may reduce thrombus in STEMI; leaves open whether it improves outcomes in randomized trials.
Study Design
Type
Observational (n=7,144)
Multicenter
Yes
Structured PICO
Does pre-treatment with unfractionated heparin reduce the risk of intracoronary thrombus and total vessel occlusion in patients with STEMI prior to percutaneous coronary intervention?
P
Population
7,144 patients with STEMI undergoing percutaneous coronary intervention in the Scandinavian TASTE trial.
E
Exposure
Pre-treatment with unfractionated heparin
C
Comparator
No heparin pre-treatment
O
Outcome
Visible intracoronary thrombus and total vessel occlusion prior to percutaneous coronary interventionsurrogate
Main Result
Odds Ratio: 0.73 (95% CI 0.65–0.83)
Absolute Event Rate: 61.3% vs 66%
p-value: p=<0.001
Pre-treatment with unfractionated heparin in STEMI patients is associated with reduced intracoronary thrombus burden and total vessel occlusion prior to PCI without increasing bleeding risk.
Cite This Study
Karlsson et al. (2017) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=7,144). Heparin pre-treatment vs. No heparin pre-treatment was evaluated on Visible intracoronary thrombus prior to percutaneous coronary intervention (OR 0.73, 95% CI 0.65-0.83, p=<0.001). Heparin pre-treatment in STEMI patients was associated with a reduced risk of intracoronary thrombus (OR 0.73; 95% CI 0.65-0.83) and total vessel occlusion (OR 0.64; 95% CI 0.56-0.73) prior to PCI.