Pretreatment with heparin in patients with ST-segment elevation myocardial infarction : a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

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Emilsson, Oskar LoveLund University (författare)

Pretreatment with heparin in patients with ST-segment elevation myocardial infarction : a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

Artikel/kapitelEngelska2022

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2022
10 s.

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LIBRIS-ID:oai:lup.lub.lu.se:da3d4983-ca72-4fb2-8336-f4ed88a0f66f
https://lup.lub.lu.se/record/da3d4983-ca72-4fb2-8336-f4ed88a0f66fURI
https://doi.org/10.4244/EIJ-D-22-00432DOI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:art swepub-publicationtype
Ämneskategori:ref swepub-contenttype

Anmärkningar

Background: Unfractionated heparin (UFH) is frequently administered before percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Aims: The aim of the study was to investigate if pretreatment with UFH prior to arrival at the catheterisation laboratory affects coronary artery occlusion, mortality, and in-hospital major bleeding in patients with STEMI undergoing PCI. Methods: Patients with a first STEMI event undergoing PCI between 2008 and 2016 were extracted from the Swedish Coronary Angiography and Angioplasty Registry. Risk ratios for UFH pretreatment versus no pretreatment regarding coronary artery occlusion at presentation in the catheterisation laboratory, 30-day mortality, and bleeding were obtained using adjusted Poisson regression models with robust standard errors. Analyses of propensity score (PS)-matched groups were performed to obtain absolute risk differences. Results: In all, 41,631 patients were included, 16,026 (38%) with and 25,605 (62%) without UFH pretreatment. Adjusted risk ratios were 0.89 (95% confidence interval [CI]: 0.87 to 0.90) for coronary artery occlusion, 0.87 (0.77 to 0.99) for mortality, and 1.01 (0.86 to 1.18) for bleeding. In the PS-matched analyses, the absolute risk differences were –0.087 (–0.074 to –0.099) for coronary artery occlusion, –0.011 (–0.017 to –0.0041) for mortality, and 0 (–0.0052 to 0.0052) for bleeding. Conclusions: Pretreatment with UFH was associated with a reduction in coronary artery occlusion among patients with STEMI, with a number needed to treat (NNT) of 12, without increasing the risk of major in-hospital bleeding. Regarding mortality, a reduction was found with UFH pretreatment, with an NNT of 94, but this effect was not robust over all sensitivity analyses and residual confounding cannot be excluded.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
bleeding
coronary occlusion
heparin
mortality
pretreatment
STEMI

Biuppslag (personer, institutioner, konferenser, titlar ...)

Bergman, SofiaLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)so3855ka (författare)
Mohammad, Moman A.Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-mm11 (författare)
Olivecrona, Göran K.Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)kard-gol (författare)
Götberg, MatthiasLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)kard-mgo (författare)
Erlinge, DavidLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)kard-der (författare)
Koul, SashaLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-sku (författare)
Lund UniversityKardiologi (creator_code:org_t)

Sammanhörande titlar

Ingår i:EuroIntervention18:9, s. 709-7181774-024X

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Av författaren/redakt...: Emilsson, Oskar ...; Bergman, Sofia; Mohammad, Moman ...; Olivecrona, Göra ...; Götberg, Matthia ...; Erlinge, David; visa fler...; Koul, Sasha; visa färre...

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Av lärosätet: Lunds universitet

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