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| Name | Class |
|---|---|
| Xiangyang Central Hospital | OTHER |
| The Central Hospital of Enshi Tujia And Miao Autonomous Prefecture | OTHER |
| Wuhan Central Hospital | OTHER |
| People's Hospital of Jingshan |
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Heparin is the first choice of anticoagulation drug for primary PCI of STEMI patients. However, the priority of use of hepairn in first medical contact or in Cathlab has not yet studied. Previous study revealed early use of antithrombotic drugs could improve patient's survival. Here we supposed that use of heparin at first medical contact could increase the TIMI flow 3 grade ratio in STEMI patients and improve patient's survival and/or reduce MACE rather than in Cathlab.
This study will recruit 944 STEMI patients undergoing primary PCI with the symptom onset within 12 hours in 36 hospitals in Hubei Province, China. The patients will be 1:1 randomly assigned to the intervention group (IG) and control group (CG). Patients in IG will be intravenously administrated with sodium heparin (100U/Kg) at first medical contact, while patients in CG will be administrated with sodium heparin (100U/Kg) through catheter sheath in the CathLab.
Inclusion Criteria:
STEMI patient; Symptom onset in 12 hours; Intended to perform PPCI. Exclusion Criteria:Active bleeding; Life expectancy less than 1 year; History of heparin-induced thrombocytopenia; Mechanical complication of MI (VSR, acute MR); History of CABG; On Coagulation drugs; CPR before randomization; Pregnant or lactating woman;Refused to sign the Informed Consent Form.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Administration of Heparin in ER | Experimental | Administration of Heparin (100U/Kg body weight) with loading dose of DAPT (Aspirin 300mg and Ticagrelor 180mg) at first medical contact for STEMI patients intended to perform PPCI. |
|
| Administration of Heparin in Cathlab | Active Comparator | Administration of Heparin (100U/Kg body weight) in Cathlab after insertion of artery sheath catheter. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Heparin Sodium Injection | Drug | Heparin Sodium Injection (100U/Kg body weight) |
|
| Measure | Description | Time Frame |
|---|---|---|
| The TIMI 3 flow of the infarct related artery before PPCI | The TIMI 3 flow of the infarct related artery at diagnostic angiography before PPCI | Coronary angiography, before PPCI,anticipated within 2 hours after randomization |
| Measure | Description | Time Frame |
|---|---|---|
| Major adverse cardiovascular or cerebrovascular event | death, cardiac death, admission for heart failure, myocardial infarction, stent thrombosis, unplanned revascularization, and stroke | 30 day and 1 year after randomization |
| Major bleeding |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jing Chen, PhD | Renmin Hospital of Wuhan University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Renmin Hospital of Wuhan university | Wuhan | Hubei | 430000 | China |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Jan 16, 2026 | |
| Reset | Feb 4, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jan 16, 2026 | Feb 4, 2026 |
| ID | Term |
|---|---|
| D000072657 | ST Elevation Myocardial Infarction |
| ID | Term |
|---|---|
| D009203 | Myocardial Infarction |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D006493 | Heparin |
| ID | Term |
|---|---|
| D006025 | Glycosaminoglycans |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
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| UNKNOWN |
| Chibi General Hospital | UNKNOWN |
| Xianning Central Hospital | OTHER |
| Hubei University of Medicine | OTHER |
| Yichang Central People's Hospital | OTHER |
| People's Hospital of Tongcheng | UNKNOWN |
| Ezhou Central Hospital | OTHER |
| Xiantao First People's Hospital | UNKNOWN |
| Songzi People's Hospital | UNKNOWN |
| Anlu People's Hospital | UNKNOWN |
| Caidian People's Hospital | UNKNOWN |
| Jiangxia First People's Hospital | UNKNOWN |
| Jingzhou Central Hospital | OTHER |
| Hubei Zhongshan Hospital | UNKNOWN |
| Guoyao Dongfeng General Hospital | UNKNOWN |
| Wuhan Puren Hospital | OTHER |
| Shiyan People's Hospital | UNKNOWN |
| General Hospital of Yangtze River shipping | UNKNOWN |
| Fifth Hospital in Wuhan | UNKNOWN |
| CR & WISCO General Hospital | UNKNOWN |
| Xishui People's Hospital | UNKNOWN |
| Jiangling People's Hospital | UNKNOWN |
| Wuhan Third Hospital | OTHER |
| Laohekou First Hospital | UNKNOWN |
| The Central Hospital of Huanggang | OTHER |
| Wuhan No.1 Hospital | OTHER |
| Hanyang University | OTHER |
| Wuxue First People's Hospital | UNKNOWN |
| Tianmen First People's Hospital | UNKNOWN |
| Xianning First People's Hospital | UNKNOWN |
| Wuhan No.6 Hospital | UNKNOWN |
| Wuhan Hospital of Traditional Chinese Medicine | OTHER |
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BARC ≥2
| 30 day after randomization |
| Complete epicardial and myocardial reperfusion after PPCI | Thrombolysis in myocardial infarction (TIMI) flow grade (TFG) 3 for epicardial reperfusion and TIMI myocardial perfusion (TMPG) grade 3 for myocardial reperfusion and complete (≥70%) ST-segment resolution of the initial sum of ST-segment elevation (STR) 90 minutes after PPCI. | within 90min after PPCI |
| D014652 |
| Vascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |