Does Thrombolytic Therapy Facilitate or Foil Primary PCI?

Sir Winston Churchill once said, “It's not enough that we do our best; sometimes we have to do what is required.” Such a sentiment underlies the premise of facilitated percutaneous coronary intervention (PCI), a therapeutic strategy of pharmacologic thrombolysis before mechanical intervention for the treatment of ST-segment elevation myocardial infarction. Despite our best efforts to provide timely primary PCI to improve myocardial salvage, patient-related delays to presentation, the necessity for transfer of the patient to a facility capable of performing PCI, and presentation of the patient to the hospital during off-hours may all conspire to extend the time from the . . .