ABSTRACT
In acute myocardial infarction, regardless of the reperfusion strategy employed, survival is a direct function of the rapidity and reliability with which patency of the infarct-related artery can be restored. While numerous clinical trials have established the efficacy of both mechanical (primary percutaneous coronary intervention [PCI]) and pharmacological (fibrinolytic therapy) approaches to achieve reperfusion, both of these therapeutic modalities possess limitations in clinical practice. Primary PCI, while generally regarded as the treatment of choice for acute ST elevation myocardial infarction (MI), is available in less than 20% of hospitals in the United States, limiting its widespread applicability (1). Fibrinolytic therapy, although universally available, is hampered by lower rates of reperfusion and higher incidences of infarct artery reocclusion and major bleeding events relative to catheter-based strategies.
