{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:32:36Z","timestamp":1789450356445,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","funder":[{"name":"University Medical Center Ljubljana","award":["20220075"],"award-info":[{"award-number":["20220075"]}]}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for patients with ST-segment\u2013elevation myocardial infarction (STEMI). We investigated the benefits and safety of pretreatment with unfractionated heparin (UFH) in patients with STEMI referred to primary PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In HEPARIN-STEMI (Pretreatment With Unfractionated Heparin for ST Elevation Myocardial Infarction)\u2014a single-center, open-label, randomized controlled trial\u2014patients with STEMI with \u22646 hours symptom duration were assigned to receive either a 70- to 100-IE\/kg bolus of UFH at first prehospital medical contact plus a supplemental dose before PCI, adjusted to activated clothing time \u2265250 seconds, or to a control group receiving standard UFH at the time of PCI. The primary efficacy end point was TIMI (Thrombolysis in Myocardial Infarction) flow grade 2\u20133 in the infarct-related artery at initial coronary angiography. The primary safety end point was BARC (Bleeding Academic Research Consortium) type 3\u20135 bleeding during the index hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      From March 2022 to February 2025, 298 patients were randomized to UFH pretreatment and 295 to the control group. The groups were comparable in age, sex, risk factors, previous cardiovascular events, and median delay from symptoms to coronary angiography (145 versus 150 minutes;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.814). The median time from UFH pretreatment to coronary angiography was 60 minutes (25th\u201375th interquartile range, 47\u201355 minutes). TIMI flow grade 2\u20133 in the infarct-related artery was documented in 43% of patients with UFH pretreatment and 27% of patients in the control group (relative risk, 1.59 [95% CI, 1.27\u20131.98];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), with no significant difference in BARC type 3\u20135 bleeding (2.4% versus 2.0%; relative risk, 1.16 [95% CI, 0.39\u20133.45];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.789).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In patients with STEMI undergoing primary PCI, in a mature STEMI network, pretreatment with UFH at first prehospital medical contact was associated with an absolute 16% increase in infarct-related artery patency without an increased risk of bleeding.<\/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: NCT05247424.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.126.079839","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:15:06Z","timestamp":1774880106000},"page":"1526-1534","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Prehospital Heparin Administration in Patients With STEMI Undergoing Primary PCI: HEPARIN-STEMI Randomized Controlled Trial"],"prefix":"10.1161","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-8756","authenticated-orcid":true,"given":"Misa","family":"Fister","sequence":"first","affiliation":[{"name":"Center for Intensive Internal Medicine, University Medical Centre Ljubljana, Slovenia (M.F., M.N., P.R., D.F., T.G.)."},{"name":"Clinical Department of Cardiology, University Medical Centre Ljubljana, Slovenia (M.B.). Medical Faculty, University of Ljubljana, Slovenia (M.F., M.N., P.R., M.B., T.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3303-4306","authenticated-orcid":true,"given":"Marko","family":"Noc","sequence":"additional","affiliation":[{"name":"Center for Intensive Internal Medicine, University Medical Centre Ljubljana, Slovenia (M.F., M.N., P.R., D.F., T.G.)."},{"name":"Clinical Department of Cardiology, University Medical Centre Ljubljana, Slovenia (M.B.). Medical Faculty, University of Ljubljana, Slovenia (M.F., M.N., P.R., M.B., T.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Radsel","sequence":"additional","affiliation":[{"name":"Center for Intensive Internal Medicine, University Medical Centre Ljubljana, Slovenia (M.F., M.N., P.R., D.F., T.G.)."},{"name":"Clinical Department of Cardiology, University Medical Centre Ljubljana, Slovenia (M.B.). Medical Faculty, University of Ljubljana, Slovenia (M.F., M.N., P.R., M.B., T.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7269-8944","authenticated-orcid":true,"given":"Matjaz","family":"Bunc","sequence":"additional","affiliation":[{"name":"Clinical Department of Cardiology, University Medical Centre Ljubljana, Slovenia (M.B.). Medical Faculty, University of Ljubljana, Slovenia (M.F., M.N., P.R., M.B., T.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6470-5785","authenticated-orcid":true,"given":"Danilo","family":"Franco","sequence":"additional","affiliation":[{"name":"Center for Intensive Internal Medicine, University Medical Centre Ljubljana, Slovenia (M.F., M.N., P.R., D.F., T.G.)."},{"name":"Department of Advanced Biomedical Science, University of Naples \u201cFederico II,\u201d Naples, Italy (D.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9051-2074","authenticated-orcid":true,"given":"Tomaz","family":"Goslar","sequence":"additional","affiliation":[{"name":"Center for Intensive Internal Medicine, University Medical Centre Ljubljana, Slovenia (M.F., M.N., P.R., D.F., T.G.)."},{"name":"Clinical Department of Cardiology, University Medical Centre Ljubljana, Slovenia (M.B.). Medical Faculty, University of Ljubljana, Slovenia (M.F., M.N., P.R., M.B., T.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the HEPARIN-STEMI Trial","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001309"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV8I11A199"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311096"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1407024"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.10.064"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.4244\/eij-d-22-00432"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.06.009"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(99)00597-5"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872617727723"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2500268"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa025142"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf481"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0303376"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.07.083"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872613508658"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.111.961425"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9149(02)02530-4"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.98.8.734"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198504043121437"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199908263410901"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.126.079839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T18:00:52Z","timestamp":1780423252000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.126.079839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":22,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2026,5,19]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.126.079839"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.126.079839","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"2026-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}