The study compared the outcomes for two drugs used to prevent blood clot formation during emergency heart attack treatment.
The study suggests that use of one of the drugs, heparin, could result in improved outcomes (such as a reduced rate of repeat heart attacks), compared to the other more expensive drug, bivalirudin.
The results of the trial suggest that systematic use of heparin rather than bivalirudin after primary percutaneous coronary intervention (PPCI) - the most commonly used treatment for heart attack, which unblocks the arteries carrying blood to the heart - could save health services substantial sums of money, at the same time as potentially improving patient outcomes.
The most commonly used antithrombotic drugs are un-fractionated heparin and bivalirudin, and although several previous trials have compared the two drugs, the evidence is unclear as to which drug results in better outcomes.
The trial took place at the Liverpool Heart and Chest Hospital in the UK, where 1,829 patients undergoing emergency angiography (an x-ray examination of the heart's arteries after a suspected heart attack) were recruited to the trial.
Within 28 days after surgery, 46 patients in the bivalirudin group died, compared to 39 of patients in the heparin group; 24 patients in the bivalirudin group had another heart attack in the same period, compared to seven patients in the heparin group.
"The results suggest that the use of heparin has some advantage over bivalirudin in avoiding major adverse events, mainly in terms of reduced recurrent, additional heart attacks in patients recovering from PPCI," said lead author Rod Stables, of the Liverpool Heart and Chest Hospital NHS Foundation Trust, UK.


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