{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:38:12Z","timestamp":1772969892083,"version":"3.50.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Evidence supporting pre-hospital heparin administration in patients with suspected non-ST segment elevation acute coronary syndrome (NSTE-ACS) is lacking. We aim to evaluate if pre-hospital heparin administration by emergency medical service improves clinical outcome in patients with suspected NSTE-ACS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients with suspected myocardial infarction (MI) presenting to the emergency department were prospectively enrolled from 2013 to 2021, excluding those with ST segment elevation MI. Patients with and without prehospital heparin administration were compared using propensity score matching. To assess the association between pre-hospital heparin loading, 30-day and 1-year mortality, Kaplan\u2013Meier estimations and Cox regression models were used.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among 1,234 patients, median age was 69\u00a0years, 755 (61.2%) were male, 867 (70.5%) with known hypertension, 177 (14.4%) had diabetes, 280 (23.1%) were current smokers, and 444 (36.0%) had a history of CAD. Compared to patients without pre-hospital heparin administration, heparin pre-treated patients were more often active smokers (26.5% vs. 20.8%). After propensity matching, 475 patients with vs. without pre-hospital heparin administration were compared, with no significant difference in 30-day mortality (no-heparin 1.3% vs. heparin 0.4%) and 1-year mortality (no-heparin 7.2% vs. heparin 5.5%, adjusted HR 0.98, CI 0.95\u20131.01, <jats:italic>p<\/jats:italic>\u2009=\u20090.22). Bleeding events occurred at a low frequency (&lt;\u20092%) and did not differ between groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In this study, pre-hospital heparin administration was not associated with improved clinical outcome in patients with suspected NSTE-ACS. These findings question pre-hospital heparin therapy in this patient population and might potentially warrant a more restricted utilization pending in-hospital risk assessment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n            <jats:p>\nPre-hospital admission of heparin in patients with suspected non-ST segment elevation acute coronary syndrome. <jats:italic>ACS<\/jats:italic> acute coronary syndrome, <jats:italic>CI<\/jats:italic> confidence interval, <jats:italic>HR<\/jats:italic> hazard ratio, <jats:italic>NSTE<\/jats:italic> non-ST segment elevation, <jats:italic>STEMI<\/jats:italic> ST-elevation myocardial infarction, <jats:italic>UFH<\/jats:italic> unfractionated heparin.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00392-024-02507-1","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T09:02:26Z","timestamp":1722848546000},"page":"738-748","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pre-hospital admission of heparin in patients with suspected non-ST segment elevation acute coronary syndrome"],"prefix":"10.1007","volume":"114","author":[{"given":"Jonas","family":"Sundermeyer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Schock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Kellner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Haller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Lehmacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklas","family":"Thie\u00dfen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bet\u00fcl","family":"Toprak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Scharlemann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Twerenbold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nils Arne","family":"S\u00f6rensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Clemmensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9478-2757","authenticated-orcid":false,"given":"Johannes T.","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,5]]},"reference":[{"issue":"38","key":"2507_CR1","doi-asserted-by":"publisher","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","volume":"44","author":"RA Byrne","year":"2023","unstructured":"Byrne RA, Rossello X, Coughlan JJ et al (2023) 2023 ESC Guidelines for the management of acute coronary syndromes. 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N Engl J Med 369(11):999\u20131010. https:\/\/doi.org\/10.1056\/nejmoa1308075","journal-title":"N Engl J Med"}],"container-title":["Clinical Research in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-024-02507-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00392-024-02507-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-024-02507-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T06:39:32Z","timestamp":1747636772000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00392-024-02507-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,5]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["2507"],"URL":"https:\/\/doi.org\/10.1007\/s00392-024-02507-1","relation":{},"ISSN":["1861-0684","1861-0692"],"issn-type":[{"value":"1861-0684","type":"print"},{"value":"1861-0692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,5]]},"assertion":[{"value":"2 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JS received travel grants from Abiomed, outside of the submitted work. PMH is funded by grants of the German Foundation for Heart Research, and the German Research Foundation (Deutsche Forschungsgemeinschaft (DFG)\u201310086\/1-1). BT receives project-related funding by the German Foundation of Heart Research, Ernst und Berta Grimmke-Stiftung (co-recipient) and Werner Otto Stiftung outside the submitted work. BT also received travel grants by the German Center for Cardiovascular Research (DZHK) and is the representative of the partner sites Hamburg\/Kiel\/L\u00fcbeck in the Use and Access Committee of the DZHK Heart Bank. PC has previously or currently been involved in research contracts, consulting, speakers bureau or received research and educational grants from: Abbott, AstraZeneca, Aventis, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Eli-Lilly, Evolva, Fibrex, Idorsia, Janssen, Merck, Myogen, Medtronic, Mitsubishi Pharma, The Medicines Company, Nycomed, Organon, Pfizer, Pharmacia, Philips, Regado, Sanofi, Searle, Servier, ViFor Pharma. JTN has received speaker honoraria\/consulting honoraria from Abbott, PHC, Roche, and Siemens. JTN, and RT are listed as co-inventors of an international patent on the use of a computing device to estimate the probability of myocardial infarction (International Publication Number WO\/2022\/043229A1), as well as co-founders and shareholders of the ARTEMIS Hamburg GmbH. RT reports research support from the German Center for Cardiovascular Research (DZHK), the K\u00fchne Foundation, the Joachim Herz Foundation, the Swiss National Science Foundation (Grant No P300PB_167803) and the Swiss Heart Foundation as well as speaker honoraria\/consulting honoraria from Abbott, Amgen, Astra Zeneca, Psyros, Roche, Siemens, Singulex and Thermo Scientific BRAHMS. All other authors reported no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}