{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:30:20Z","timestamp":1791570620940,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early dual antiplatelet therapy (DAPT) improves outcomes in ST\u2010elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Although guidelines recommend prompt P2Y12 inhibitor use, the optimal timing of administration, particularly prehospital versus in\u2010hospital delivery, remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated whether prehospital ticagrelor loading plus aspirin improves coronary reperfusion and outcomes compared with in\u2010hospital administration in STEMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 428 consecutive STEMI patients treated with primary PCI between January 2023 and December 2025. Patients received ticagrelor 180\u2009mg and aspirin 300\u2009mg either prehospital via emergency medical services (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009186) or after emergency department arrival (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009242). The primary endpoint was post\u2010PCI Thrombolysis in Myocardial Infarction (TIMI) flow grade 3. Secondary endpoints included myocardial blush grade (MBG), ST\u2010segment resolution, 30\u2010day major adverse cardiovascular events (MACE), and bleeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TIMI 3 flow occurred more frequently with prehospital DAPT than with in\u2010hospital administration (91.4% vs. 82.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). Complete ST\u2010segment resolution (\u2265\u200970%) was higher in the prehospital group (76.3% vs. 64.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), as was MBG 2\u20133 (84.9% vs. 74.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Time from first medical contact to DAPT was shorter prehospital (8 vs. 42\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Prehospital DAPT independently predicted TIMI 3 flow (OR 2.18, 95% CI 1.24\u20133.84). Thirty\u2010day MACE was reduced (5.4% vs. 11.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038), without increased major bleeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prehospital ticagrelor plus aspirin is associated with superior reperfusion and improved short\u2010term outcomes without excess bleeding, supporting routine implementation within emergency medical services. These findings may inform systems of care and optimize early pharmacologic strategies worldwide in practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70448","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:39:46Z","timestamp":1787035186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Prehospital Ticagrelor Loading Dose Combined With Aspirin Dual Antiplatelet Therapy on Post\u2010PCI TIMI Flow Grade in Patients With ST\u2010Elevation Myocardial Infarction"],"prefix":"10.1002","volume":"49","author":[{"given":"Pingwei","family":"Liu","sequence":"first","affiliation":[{"name":"Xinping Yi and Dai Autonomous County People's Hospital Yuxi City Yunnan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangsheng","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Coronary artery Disease I Yunnan Fuwai Cardiovascular Specialized Hospital Kunming City Yunnan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis Yunnan provincial Infectious Disease Hospital Kunming City Yunnan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8427-5274","authenticated-orcid":false,"given":"Qirong","family":"He","sequence":"additional","affiliation":[{"name":"Comprehensive Internal Medicine Department Yunnan Provincial Infectious Diseases Hospital Anning City Yunnan Province 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