HEAT-PPCI: A clear and welcome win for heparin

The use of bivalirudin during primary percutaneous coronary intervention (PPCI) is perceived to be associated with less bleeding compared to unfractionated heparin (UFH). However, evidence supporting this observation is confounded by the frequent co-administration of glycoprotein IIb/IIIa inhibitors in the UFH arm in the majority of previous large trials. The “How Effective Are Antithrombotic Therapies in Primary PCI (HEAT-PPCI)” trial was conducted to test the efficacy and safety of UFH vesrus bivalirudin in patients undergoing PPCI when GP IIb/IIIa inhibitors are used selectively.