Acute-phase strategies can critically influence outcomes in patients undergoing percutaneous coronary intervention. Evidence presented at the European Society of Cardiology Congress 2025 examined aspirin reloading in patients on chronic aspirin therapy undergoing percutaneous coronary intervention. 

In this multicenter retrospective cohort study spanning 2010 to 2024, fifty-two thousand nine hundred twenty-nine patients from eighty-two hospitals were included. Patients receiving aspirin reloading (three hundred milligrams within twenty-four hours pre-procedure) were compared with those on maintenance therapy (one hundred milligrams). Propensity score matching yielded eight thousand six hundred twenty-six well-balanced pairs. 

The aspirin reload group demonstrated a significantly lower incidence of major adverse cardiovascular and cerebrovascular events at one month (1.69% vs 3.41%; hazard ratio 0.51). This benefit attenuated at three and six months. Myocardial infarction and target vessel revascularization reductions persisted at six months. No increase in cardiac death, stroke, or bleeding events was observed. 

These findings indicate that acute-phase aspirin reloading provides short-term protection in high-risk patients, highlighting the need for randomized studies to determine optimal dosing and timing.