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[Department of Ethics] Delayed consent: will there be a shift in approach for US primary percutaneous coronary intervention trials?

No doubt the HEAT-PPCI (How Effective Are Antithrombotic Therapies in Primary PCI) study presented at the American College of Cardiology 2014 Scientific Sessions in March, 2014, continues to elicit much controversy and discussion—and not limited to the outcome of the trial. HEAT-PPCI reported that unfractionated heparin (UFH) outperformed bivalirudin for 28 days outcome in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).