# Early unfractionated heparin treatment in patients with STEMI – trial design and rationale

## TL;DR

This study tests if giving heparin early to heart attack patients improves artery openness and outcomes.

## Contribution

The study investigates early unfractionated heparin administration in STEMI patients to improve coronary artery patency.

## Key findings

- The trial aims to assess if early heparin improves infarct-related artery patency in STEMI patients.
- Primary endpoint is TIMI flow grades 2 and 3 on diagnostic coronary angiography.
- Safety outcomes include bleeding complications and 30-day mortality.

## Abstract

The early unfractionated heparin (UFH) treatment in patients with ST-elevation myocardial infarction (STEMI) is a single-center, open-label, randomized controlled trial. The study population are patients with STEMI that undergo primary percutaneous coronary intervention (PPCI). The trial was designed to investigate whether early administration of unfractionated heparin immediately after diagnosis of STEMI is beneficial in terms of patency of infarct-related coronary artery (IRA) when compared to established UFH administration at the time of coronary intervention. The patients will be randomized in 1:1 fashion in one of the two groups. The primary efficacy endpoint of the study is Thrombolysis in myocardial infarction (TIMI) flow grades 2 and 3 on diagnostic coronary angiography. Secondary outcome measures are: TIMI flow after PPCI, progression to cardiogenic shock, 30-day mortality, ST-segment resolution, highest Troponin I and Troponin I values at 24 hours. The safety outcome is bleeding complications. The study of early heparin administration in patients with STEMI will address whether pretreatment with UFH can increase the rate of spontaneous reperfusion of infarct-related coronary artery.