INTRODUCTION For patients with ST segment elevation myocardial infarction (STEMI), the time elapsed between the onset of pain and initiation of reperfusion has a critical impact on prognosis (1-4). Thus, all current guidelines concur in emphasizing the importance of initiating reperfusion therapy as soon as possible, either by mechanical or by pharmacological means (angioplasty and fibrinolysis, respectively) (5,6). Thus, although angioplasty is generally regarded as being superior to fibrinolysis, it is accepted that fibrinolysis should be initiated if angioplasty cannot be performed promptly and expertly (5,7). Moreover, in patients treated soon after the onset of pain, fibrinolysis or angioplasty is associated with favorable outcomes (8,9).