{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:11:05Z","timestamp":1790122265169,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate the incidence and prognosis of spontaneous coronary reperfusion in STEMI using pre\u2010hospital loading dose of P2Y12 inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective bi\u2010centric study included STEMI patients who referred for primary PCI from June 1, to November 1, 2022. All patients received before hospital admission loading dose of aspirin, heparin and P2Y\n                      <jats:sub>12<\/jats:sub>\n                      inhibitor. The primary outcome was incidence of spontaneous coronary reperfusion (TIMI 3 flow) before primary PCI. Major in\u2010hospital and 1\u2010year events were secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Within the study period, 263 patients were admitted with ongoing STEMI and 49 of them (18.6%) had spontaneous coronary reperfusion with no significant difference between loading dose of ticagrelor (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009226; 85.9%) or clopidogrel (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927, 10.3%) and TIMI 3 flow (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200941; 18.1% vs.\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097; 25.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.53; respectively). Peak of T\u2010hs troponin (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and CRP (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) were significantly lower in the TIMI 3 group. In multivariate analysis, out\u2010of\u2010 hospital cardiac arrests were observed twice as often in the TIMI 3 group (16.33 vs. 7.01%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044). There was no significant difference between the two groups regarding major in\u2010hospital (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.69) or 1\u2010year major events (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.20).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Spontaneous reperfusion at admission was observed in about 20% of STEMI patients who received a pre\u2010hospital loading dose of antithrombotic therapy including P2Y\n                      <jats:sub>12<\/jats:sub>\n                      inhibitors, and was associated with markers of decrease of infarct size. The significant increase of pre\u2010admission cardiac arrests observed in the TIMI 3 group could be specifically explored as it might be a concern regarding future pre\u2010hospital reperfusion therapy strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70418","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:33:32Z","timestamp":1784370812000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous Coronary Reperfusion in STEMI After Pre\u2010Hospital Loading Dose of Triple Antithrombotic Therapy"],"prefix":"10.1002","volume":"49","author":[{"given":"Pierre Alain","family":"Meunier","sequence":"first","affiliation":[{"name":"Department of Cardiology CHU Montpellier Montpellier 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