Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effects of early application of heparin on coronary blood flow during primary percutaneous coronary intervention

Shutian Shi, Lei Zhen, Mei Wang, Chunmei Wang, Hui Ai, Bin Que, Shaoping Nie

Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;

For correspondence:- Shaoping Nie Email: spnie@126.com Tel:+8617896008239

Accepted: 28 July 2023 Published: 31 August 2023

Citation: Shi S, Zhen L, Wang M, Wang C, Ai H, Que B, et al. Effects of early application of heparin on coronary blood flow during primary percutaneous coronary intervention. Trop J Pharm Res 2023; 22(8):1691-1698 doi: 10.4314/tjpr.v22i8.21

© 2023 The authors.
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Abstract

Purpose: To investigate the efficacy and safety of unfractionated heparin (UFH) anticoagulant administered upstream in the ambulance or emergency room during primary percutaneous coronary intervention (pPCI) for patients with acute ST-segment elevation myocardial infarction (STEMI).

Methods: The study included STEMI patients who received either early UFH subcutaneously (SC) (n = 163) or intraoperative UFH (SC) during pPCI (n = 476) between January 2017 to August 2018. Baseline characteristics, infarct-related artery (IRA) status, and procedural characteristics were analyzed. The primary endpoint was thrombolysis in myocardial infarction (TIMI) flow grade 2 - 3 before intervention. The secondary endpoints were time from first medical contact to guidewire passage, postoperative TIMI 3 flow grade, acute stent thrombosis, and in-hospital bleeding events.

Results: Baseline characteristics were similar between the groups, with no significant difference in IRA location. Both groups underwent coronary angiography, with most patients receiving pPCI. The primary endpoint occurred in 18.1 % of patients in intraoperative UFH group and 27.6 % in the early UFH group, with a significant difference between the groups (p < 0.05). There was no significant difference in postoperative TIMI 3 flow grade or acute stent thrombosis, but bleeding events (BARC 2-5) were similar between groups (1.1 % in intraoperative group and 1.8 % in early UFH group, p > 0.05)

Conclusion: Early upstream administration of UFH anticoagulation in STEMI patients improves coronary artery potency before pPCI, and early use of fixed-dose UFH is safe and does not increase major bleeding complications.

Keywords: Acute ST-segment elevation myocardial infarction; Primary percutaneous coronary intervention; Heparin