Tag Archives: primary PCI

Introduction Despite primary percutaneous coronary intervention (pPCI) programmes,1-3 ST-elevation myocardial infarction (STEMI) is associated with significant morbidity and mortality.2,3 Total ischaemic time predicts mortality in STEMI,4,5 and was adopted by the European Society of Cardiology (ESC) in the most recent STEMI guidelines.3 This time-period starts at the onset of chest pain and ends at wire cross, including onset-to-door and door-to-balloon time, and outcomes worsen beyond 120 minutes.6 The ESC guideline advises optimal time cut-offs for each step. This document re-highlights ‘time is muscle’, first described by Braunwald 50

HEAT-PPCI: heparin outperforms bivalirudin in primary PCI The major talking point of this year’s American College of Cardiology meeting was without doubt the aptly named HEAT-PPCI trial which generated more heat than has been seen at such conferences for quite some time. The trial acronym stands for How Effective Are Antithrombotic Therapies in Primary PCI (percutaneous coronary intervention), and the study – conducted in the UK under the leadership of Dr Rod Stables (Liverpool Heart and Chest Hospital) – compared unfractionated heparin with bivalirudin (Angiomax®, the Medicines Company) in patients with ST-elevation myoca