INTRODUCTION Acute myocardial infarction is the leading cause of morbidity and mortality and results from thrombotic occlusion of a major epicardial coronary artery. Primary percutaneous coronary intervention (PCI) is the treatment of choice in patients with acute ST elevation myocardial infarction (STEMI) to improve myocardial salvage by effectively reestablishing coronary perfusion. Randomized clinical trials consistently demonstrated superiority of catheter-based reperfusion of the infarct-related artery (IRA) over fibrinolysis with respect to short-and long-term mortality, nonfatal reinfarction, and hemorrhagic stroke (1). A comprehensive approach with effective integration of potent antithrombotic therapy in combination with timely percutaneous coronary revascularization led to a significant decline in mortality and has prevailed in the contemporary management of acute myocardial infarction.