{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:42:40Z","timestamp":1790102560777,"version":"4.0.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,4,16]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Postprocedural anticoagulation (PPA) is frequently administered after primary percutaneous coronary intervention in ST-segment\u2013elevation myocardial infarction, although no conclusive data support this practice.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>The RIGHT trial (Comparison of Anticoagulation Prolongation vs no Anticoagulation in STEMI Patients After Primary PCI) was an investigator-initiated, multicenter, randomized, double-blind, placebo-controlled, superiority trial conducted at 53 centers in China. Patients with ST-segment\u2013elevation myocardial infarction undergoing primary percutaneous coronary intervention were randomly assigned by center to receive low-dose PPA or matching placebo for at least 48 hours. Before trial initiation, each center selected 1 of 3 PPA regimens (40 mg of enoxaparin once daily subcutaneously; 10 U\u00b7kg\u00b7h of unfractionated heparin intravenously, adjusted to maintain activated clotting time between 150 and 220 seconds; or 0.2 mg\u00b7kg\u00b7h of bivalirudin intravenously). The primary efficacy objective was to demonstrate superiority of PPA to reduce the primary efficacy end point of all-cause death, nonfatal myocardial infarction, nonfatal stroke, stent thrombosis (definite), or urgent revascularization (any vessel) within 30 days. The key secondary objective was to evaluate the effect of each specific anticoagulation regimen (enoxaparin, unfractionated heparin, or bivalirudin) on the primary efficacy end point. The primary safety end point was Bleeding Academic Research Consortium 3 to 5 bleeding at 30 days.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Between January 10, 2019, and September 18, 2021, a total of 2989 patients were randomized. The primary efficacy end point occurred in 37 patients (2.5%) in both the PPA and placebo groups (hazard ratio, 1.00 [95% CI, 0.63 to 1.57]). The incidence of Bleeding Academic Research Consortium 3 to 5 bleeding did not differ between the PPA and placebo groups (8 [0.5%] vs 11 [0.7%] patients; hazard ratio, 0.74 [95% CI, 0.30 to 1.83]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Routine PPA after primary percutaneous coronary intervention was safe but did not reduce 30-day ischemic events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03664180.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.123.067079","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T10:00:47Z","timestamp":1708941647000},"page":"1258-1267","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Postprocedural Anticoagulation After Primary Percutaneous Coronary Intervention for ST-Segment\u2013Elevation Myocardial Infarction: A Multicenter, Randomized, Double-Blind Trial"],"prefix":"10.1161","volume":"149","clinical-trial-number":[{"clinical-trial-number":"nct03664180","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8399-4818","authenticated-orcid":true,"given":"Yan","family":"Yan","sequence":"first","affiliation":[{"name":"Center for Coronary Artery Disease (Y.Y., X.W., W.G., S.N.), Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China."},{"name":"National Clinical Research Center of Cardiovascular Diseases, Beijing, China (Y.Y., X.W., W.G., C.M., S.N.)."},{"name":"Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China (Y.Y., X.W., W.G., C.M., S.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6173-6386","authenticated-orcid":true,"given":"Jincheng","family":"Guo","sequence":"additional","affiliation":[{"name":"Beijing Luhe Hospital, Capital Medical University, Beijing, China (J.G., G.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8420-8911","authenticated-orcid":true,"given":"Xiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Coronary Artery Disease (Y.Y., X.W., W.G., S.N.), Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China."},{"name":"National Clinical Research Center of Cardiovascular Diseases, Beijing, China (Y.Y., X.W., W.G., C.M., S.N.)."},{"name":"Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China (Y.Y., X.W., W.G., C.M., S.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guozhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Luhe Hospital, Capital Medical University, Beijing, China (J.G., G.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Civil Aviation General Hospital, Beijing, China (Z.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delu","family":"Yin","sequence":"additional","affiliation":[{"name":"The First People\u2019s Hospital of Lianyungang, Jiangsu, China (D.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9875-9725","authenticated-orcid":true,"given":"Zhifang","family":"Wang","sequence":"additional","affiliation":[{"name":"Xinxiang Central Hospital, Henan, China (Z.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuchun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Haidian Hospital, Beijing, China (F.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changming","family":"Tian","sequence":"additional","affiliation":[{"name":"The People\u2019s Hospital of Yongcheng, Henan, China (C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Gong","sequence":"additional","affiliation":[{"name":"Center for Coronary Artery Disease (Y.Y., X.W., W.G., S.N.), Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China."},{"name":"National Clinical Research Center of Cardiovascular Diseases, Beijing, China (Y.Y., X.W., W.G., C.M., S.N.)."},{"name":"Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China (Y.Y., X.W., W.G., C.M., 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