In STEMI treatment, which reperfusion strategy is preferred when PCI-capable facilities are available?

In STEMI treatment, which reperfusion strategy is preferred when PCI-capable facilities are available?

• A. Primary PCI
• B. Thrombolysis
• C. Medical therapy only
• D. Heart surgery

Answer: (A)

Opening the blocked artery as quickly as possible is the core aim in STEMI. When a facility with PCI capability can treat the patient promptly, primary PCI is preferred because it directly restores blood flow by mechanically opening the culprit artery, usually with stent placement to keep it open. This method tends to achieve reliable reperfusion, lowers the chances of re-occlusion, and improves survival compared with thrombolytic therapy. It also carries a lower risk of major bleeding, including intracranial hemorrhage, than fibrinolysis. Because of these advantages, PCI performed as the first-line reperfusion strategy is favored if it can be done in a timely fashion. Thrombolysis becomes an alternative when PCI cannot be performed quickly enough, whereas medical therapy alone does not revascularize the blocked vessel, and heart surgery is not the preferred initial reperfusion strategy when PCI is readily available.

Opening the blocked artery as quickly as possible is the core aim in STEMI. When a facility with PCI capability can treat the patient promptly, primary PCI is preferred because it directly restores blood flow by mechanically opening the culprit artery, usually with stent placement to keep it open. This method tends to achieve reliable reperfusion, lowers the chances of re-occlusion, and improves survival compared with thrombolytic therapy. It also carries a lower risk of major bleeding, including intracranial hemorrhage, than fibrinolysis. Because of these advantages, PCI performed as the first-line reperfusion strategy is favored if it can be done in a timely fashion.

Thrombolysis becomes an alternative when PCI cannot be performed quickly enough, whereas medical therapy alone does not revascularize the blocked vessel, and heart surgery is not the preferred initial reperfusion strategy when PCI is readily available.