ABSTRACT
The challenge facing proponents of pharmacoinvasive therapy (1) lies in translating the potential synergistic benefits of a combined pharmacological and mechanical reperfusion strategy into real-world, clinical benefits. Evaluation of combined reperfusion strategies must consider the individual risks of each component of pharmacoinvasive therapy in selecting appropriate target populations, study protocols, and endpoints. This chapter will provide an overview of central issues in modern-day clinical trials of pharmacoinvasive therapy for ST segment elevation myocardial infarction (STEMI) as well as a review of previous, ongoing, and terminated trials, with an emphasis on trial design and the challenges facing clinical design in this arena.
