Research shows no advantage of ambulance over hospital administered anti-clotting therapy on outcome or survival rates. Photo by DarkoStojanovic/PixaBay

Aug. 29 (UPI) -- New research suggests there is no advantage to anti-clot therapy given in an ambulance versus waiting until patients get to the hospital.

European and American guidelines recommend pre-hospital antiplatelet treatment for heart attack patients having ST-elevation myocardial infarction, or STEMI.


"Pre-hospital administration is common practice -- despite the lack of definite evidence for its benefit," Dr. Elmir Omerovic, of Sahlgrenska University Hospital in Gothenburg, Sweden, said in a press release.

"But our study -- which is the largest cohort study conducted so far -- adds to some previous evidence suggesting there is potential for harm. In fact, inadvertent prehospital administration of these drugs to patients with contraindications to antithrombotic therapy is common. Therefore, considering all current evidence, we think pre-hospital administration should be discouraged."

RELATED Higher death rate in women after ER stay for heart arrhythmias

The study, presented this week at the ESC Congress 2017, used data from the Swedish Coronary Angiography and Angioplasty Registry, or SCAAR, of 44,804 STEMI patients who underwent percutaneous coronary intervention, or PCI, between 2005 and 2016.

The majority of patients in the study were pre-treated with antiplatelet therapy, however, 6,964 were not pre-treated. Researchers found no significant benefits to pre-treatment in relation to 30-day mortality rates or other indicators such as measures of arterial blockage, cardiogenic shock, or neurological or bleeding complications.

The previous ATLANTIC trial was the first to find that pre-treatment made no significant difference in outcomes.

"Our new data addresses some of the concerns with ATLANTIC and offers stronger evidence that pre-treatment is not necessary," Omerovic said. "We hope the accumulated evidence will be convincing enough to discourage this practice and trigger a change in recommendations."