Pharmacoinvasive Management.

The goal of treatment of patients with ST-segment elevation myocardial infarction (STEMI) is timely restoration of myocardial blood flow. Primary percutaneous coronary intervention (PCI) remains the treatment of choice for STEMI patients, as shown in multiple clinical trials. However, because of logistic constraints, timely primary PCI may not be possible for many STEMI patients, most of whom are treated with fibrinolysis. Debate continues as to whether, and when, patients treated with fibrinolysis should undergo subsequent PCI. Current data support the strategy of early routine PCI after fibrinolysis rather than the conservative standard-care approach or rescue PCI for failed lysis.