{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:48:37Z","timestamp":1788400117216,"version":"build-2803163510"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,7]]},"abstract":"\n Background<\/jats:title>\n \n Few data are available regarding the optimal management of ST\u2010elevation myocardial infarction patients with clinically defined spontaneous reperfusion (\n SR<\/jats:styled-content>\n ). We report on the characteristics and outcomes of patients with\n SR<\/jats:styled-content>\n in the primary percutaneous coronary intervention era, and assess whether immediate reperfusion can be deferred.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Data were drawn from a prospective nationwide survey,\n ACSIS<\/jats:styled-content>\n (Acute Coronary Syndrome Israeli Survey). Definition of\n SR<\/jats:styled-content>\n was predefined as both (1) \u226570% reduction in\n ST<\/jats:styled-content>\n \u2010segment elevation on consecutive\n ECG<\/jats:styled-content>\n s and (2) \u226570% resolution of pain. Of 2361 consecutive ST\u2010elevation\u2013acute coronary syndrome patients in Killip class 1, 405 (17%) were not treated with primary reperfusion therapy because of\n SR<\/jats:styled-content>\n . Intervention in\n SR<\/jats:styled-content>\n patients was performed a median of 26\u00a0hours after admission. These patients were compared with the 1956 ST\u2010elevation myocardial infarction patients who underwent primary reperfusion with a median door\u2010to\u2010balloon of 66\u00a0minutes (interquartile range 38\u2013106). Baseline characteristics were similar except for slightly higher incidence of renal dysfunction and prior angina pectoris in\n SR<\/jats:styled-content>\n patients. Time from symptom onset to medical contact was significantly greater in\n SR<\/jats:styled-content>\n patients. Patients with\n SR<\/jats:styled-content>\n had significantly less in\u2010hospital heart failure (4% versus 11%) and cardiogenic shock (0% versus 2%) (\n P<\/jats:italic>\n <0.01 for all). No significant differences were found in in\u2010hospital mortality (1% versus 2%), 30\u2010day major cardiac events (4% versus 4%), and mortality at 30 days (1% versus 2%) and 1 year (4% versus 4%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Patients with clinically defined\n SR<\/jats:styled-content>\n have a favorable prognosis. Deferring immediate intervention seems to be safe in patients with clinical indices of spontaneous reperfusion.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004552","type":"journal-article","created":{"date-parts":[[2017,7,26]],"date-time":"2017-07-26T00:10:40Z","timestamp":1501027840000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Outcomes of Patients Presenting With Clinical Indices of Spontaneous Reperfusion in ST\u2010Elevation Acute Coronary Syndrome Undergoing Deferred Angiography"],"prefix":"10.1161","volume":"6","author":[{"given":"Paul","family":"Fefer","sequence":"first","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Beigel","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaul","family":"Atar","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Galilee Medical Center, Nahariya, Israel"},{"name":"Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doron","family":"Aronson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rambam Healthcare Campus and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Pollak","sequence":"additional","affiliation":[{"name":"Heart Institute, Hadassah University Hospital, Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doron","family":"Zahger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elad","family":"Asher","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaza","family":"Iakobishvili","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Shlomo","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny","family":"Alcalai","sequence":"additional","affiliation":[{"name":"Heart Institute, Hadassah University Hospital, Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Einhorn\u2010Cohen","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Segev","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomi","family":"Matetzky","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the ACSIS (Acute Coronary Syndrome Israeli Survey) Study 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R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2015. Available at: https:\/\/www.R-project.org\/. Accessed July 31, 2016."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v042.i07"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi606"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00210-U"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00466-0"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.004552","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:31:59Z","timestamp":1715596319000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.004552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1161\/JAHA.116.004552"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.004552","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"assertion":[{"value":"2016-08-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-04-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004552"}}