Antithrombotic Therapy to Support Primary PCI

The goals of the initial management of ST-segment elevation myocardial infarction include swift restoration of flow within the occluded coronary artery, prevention of early reinfarction, and avoidance of complications of reperfusion therapy.1,2 The selection of the reperfusion strategy, either the preferred percutaneous coronary intervention (PCI) or fibrinolysis, is usually driven by institutional access to primary PCI. Thus, the decision that clinicians most commonly grapple with at the time of the patient's presentation is the selection of adjunctive anticoagulant and antiplatelet therapy. In this issue of the Journal, Stone and colleagues report on a large, randomized trial that tested an . . .