Combination antithrombotic management of stemi with pharmacoinvasive strategy, primary PCI, or rescue PCI

The mainstay of acute ST segment elevation myocardial infarction (STEMI) emergent management consists of reperfusion therapy combined with antithrombotic treatment. Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for STEMI. Rescue PCI consists of urgent transfer for PCI of patients with failed fibrinolysis. The pharmacoinvasive strategy consists of administration of fibrinolysis followed by immediate transfer to a PCI-capable hospital for routine early catheterization. This article provides an overview of data and recommendations on primary PCI, rescue PCI, and pharmacoinvasive strategy as well as of the antithrombotic regimens used to support STEMI reperfusion approaches. © 2013 Elsevier Inc.