PMID- 26159240
OWN - NLM
STAT- MEDLINE
DCOM- 20160622
LR  - 20150831
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 198
DP  - 2015 Nov 1
TI  - Time-dependent effects of unfractionated heparin in patients with ST-elevation 
      myocardial infarction transferred for primary angioplasty.
PG  - 70-4
LID - S0167-5273(15)01310-8 [pii]
LID - 10.1016/j.ijcard.2015.06.009 [doi]
AB  - AIMS: Initial thrombolysis in myocardial infarction (TIMI) flow and mortality are 
      related in ST-elevation myocardial infarction (STEMI) patients treated with 
      primary angioplasty (PPCI). It is unclear whether early adjunctive treatment with 
      unfractionated heparin (UFH) is beneficial for coronary patency. We investigated 
      the effect of UFH administered before transfer versus in the catheterization 
      laboratory (CathLab) on initial patency of the infarct related artery (IRA) in 
      transferred STEMI patients treated with PPCI. METHODS AND RESULTS: Consecutive 
      STEMI patients (n=1326, February 2007-December 2013) were allocated in two groups 
      relative to UFH administration: pre-transfer group - administration by ambulance 
      crew or physician-in-charge at the non-PPCI centre, 758 patients (57%); 
      post-transfer group - administration in the CathLab, 568 patients (43%). The time 
      range between symptom onset (SO) and UFH administration (SO-UFH) was assessed and 
      the 1-year mortality prediction was analysed by logistic regression. Initial IRA 
      TIMI 2-3 flow was 30.3% in pre-transfer group vs. 21.2% in post-transfer group 
      (p<0.001). A time-dependent association was found between SO-UFH and initial TIMI 
      2-3 in pre- vs. post-transfer groups [<120 min: 33.2% vs. 18%, p<0.001; 120-240 
      min: 29.2% vs. 22.8%, p=0.18; >240 min: 25% vs. 28%, p=0.57]. No differences in 
      major bleeding were found between groups. UFH administration before transfer 
      remained an independent predictor for initial TIMI 2-3 flow (OR 1.60 CI 95% 
      1.22-2.11, p=0.01) and for 1-year mortality (OR 0.51 CI 95% 0.29-0.91, p=0.02). 
      CONCLUSIONS: Early UFH administration in STEMI patients transferred for PPCI 
      results in higher IRA initial patency in a time-dependent manner and improves 
      clinical outcomes.
CI  - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved.
FAU - Giralt, Teresa
AU  - Giralt T
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain. Electronic address: teresagiralt@gmail.com.
FAU - Carrillo, Xavier
AU  - Carrillo X
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain; Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, 
      Spain.
FAU - Rodriguez-Leor, Oriol
AU  - Rodriguez-Leor O
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain; Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, 
      Spain.
FAU - Fernandez-Nofrerias, Eduard
AU  - Fernandez-Nofrerias E
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain.
FAU - Rueda, Ferran
AU  - Rueda F
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain.
FAU - Serra-Flores, Jordi
AU  - Serra-Flores J
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain.
FAU - Viguer, Josep Maria
AU  - Viguer JM
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain.
FAU - Mauri, Josepa
AU  - Mauri J
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain.
FAU - Curos, Antoni
AU  - Curos A
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain.
FAU - Bayes-Genis, Antoni
AU  - Bayes-Genis A
AD  - Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, 
      Spain; Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, 
      Spain.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20150624
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Anticoagulants/*administration & dosage
MH  - Emergency Medical Services/methods
MH  - Female
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/*therapy
MH  - Patient Transfer/*methods
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vascular Patency/drug effects/physiology
OTO - NOTNLM
OT  - Heparin
OT  - Primary angioplasty
OT  - STEMI
EDAT- 2015/07/15 06:00
MHDA- 2016/06/23 06:00
CRDT- 2015/07/11 06:00
PHST- 2015/01/26 00:00 [received]
PHST- 2015/04/22 00:00 [revised]
PHST- 2015/06/12 00:00 [accepted]
PHST- 2015/07/11 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2016/06/23 06:00 [medline]
AID - S0167-5273(15)01310-8 [pii]
AID - 10.1016/j.ijcard.2015.06.009 [doi]
PST - ppublish
SO  - Int J Cardiol. 2015 Nov 1;198:70-4. doi: 10.1016/j.ijcard.2015.06.009. Epub 2015 
      Jun 24.