Initiate to all patients within 12 hours of symptom onset if has no contraindications.
It beneficial up to at least 24 hours if there is evidence of ongoing ischemia
Contraindictions:
1) Intolerance of long-term antiplatelet therapy
2) A relative contraindication is the presence of any significant comorbid conditions that severely limit the lifespan of the patient such as cancer
Primary PCI is preferable to fibrinolysis if performed by an experienced team within 120 minutes of first medical contact
Primary PCI is indicated in all patients with STEMI and cardiogenic shock or severe acute heart failure
In PCI for STEMI, use either a bare-metal or drug-eluting stent; use a bare-metal stent in patients with high bleeding risk, inability to comply with 1 year of dual antiplatelet therapy, or upcoming invasive procedure
In comatose patients, use therapeutic hypothermia