Effects of the early administration of heparin in patients with ST-elevation myocardial infarction treated by primary angioplasty

Woo Young Chung, Mi Jung Han, Young Seok Cho, Kwang Il Kim, Hyuk Jai Chang, Tae Jin Youn, In Ho Chae, Dong Ju Choi, Cheol Ho Kim, Byung Hee Oh, Young Bae Park, Yun Shik Choi

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Abstract

Background: The effect of adjunctive heparin for primary angioplasty in patients with ST-elevation myocardial infarction (STEMI) is not well established, so the authors investigated the effect of early heparin administration in the emergency room (ER) on initial patency of the infarct-related artery (IRA) and on the clinical outcome in STEMI patients. Methods and Results: One hundred and twenty consecutive patients who presented with STEMI less than 12 h from pain onset and who were eligible for primary percutaneous coronary intervention were allocated to an early heparin group (heparin administered in ER) or a late heparin group (heparin administered after angiography). In the early heparin group, unfractionated heparin (60 U/kg bolus IV, then 14U·kg-1·h-1 IV infusion) or enoxaparin (1 mg/kg bolus SC) were administered 144±95 min before angioplasty. No significant differences in baseline characteristics were observed between the early heparin group (n=56) and the late heparin group (n=64). However, initial Thrombolysis In Myocardial Infarction (TIMI) flow grade in the IRA was significantly different between the 2 groups (frequency of TIMI 0/1/2/3; 48/4/7/41% vs 70/8/11/11%, early vs late respectively, p=0.002). TIMI 2 or 3 flow was significantly more frequent in the early heparin group than in the late heparin group (48% vs 22%, p=0.002). However, no significant differences were noted between the 2 groups in terms of in-hospital major adverse cardiac events (7% vs 11%, p=0.472) and TIMI major bleeding (2% vs 3%, p=0.639). Conclusions: In STEMI patients, early heparin therapy administered in the ER improves coronary patency, despite not reaching clinical benefit.

Original languageEnglish
Pages (from-to)862-867
Number of pages6
JournalCirculation Journal
Volume71
Issue number6
DOIs
Publication statusPublished - 2007

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Chung, W. Y., Han, M. J., Cho, Y. S., Kim, K. I., Chang, H. J., Youn, T. J., Chae, I. H., Choi, D. J., Kim, C. H., Oh, B. H., Park, Y. B., & Choi, Y. S. (2007). Effects of the early administration of heparin in patients with ST-elevation myocardial infarction treated by primary angioplasty. Circulation Journal, 71(6), 862-867. https://doi.org/10.1253/circj.71.862