Reperfusion At a PCI-Capable Hospital
ÎÎPrimary PCI should be performed in patients with STEMI and ischemic
symptoms of <12 hours' duration. (I-A)
ÎÎPrimary PCI should be performed in patients with STEMI and ischemic
symptoms of <12 hours' duration who have contraindications to
fibrinolytic therapy, irrespective of the time delay from FMC. (I-B)
ÎÎPrimary PCI should be performed in patients with STEMI and
cardiogenic shock or acute severe heart failure (HF), irrespective of
time delay from MI onset. (I-B)
ÎÎPrimary PCI is reasonable in patients with STEMI if there is clinical
and/or ECG evidence of ongoing ischemia between 12 and 24 hours
after symptom onset. (IIa-B)
ÎÎPCI should NOT be performed in a noninfarct artery at the time of
primary PCI in patients with STEMI who are hemodynamically stable.
(III-B: Harm)
Table 2. Primary PCI in STEMI
CORa
LOEa
Ischemic symptoms <12 h
I
A
Ischemic symptoms <12 h and contraindications to fibrinolytic
therapy irrespective of time delay from FMC
I
B
Cardiogenic shock or acute severe HF irrespective of time delay
from MI onset
I
B
IIa
B
III: Harm
B
Evidence of ongoing ischemia 12-24 h after symptom onset
PCI of a noninfarct artery at the time of primary PCI in
patients without hemodynamic compromise
a
COR, Class of Recommendation; LOE, Level of Evidence
3
