Types of percutaneous coronary interventions in ST-segment elevation myocardial infarction

In ST-segment elevation myocardial infarction (STEMI), various types of percutane­ous coronary intervention (PCI) are performed depending on the disease duration, persistent disease symptoms, and prior thrombolytic therapy. The aim of this review is to present all PCI types that can be performed in the treatment of patients with STEMI, substantiate the indications for their use, and the optimal option for endovascular intervention. Basically, three following types of PCI used in patients with STEMI are distinguished: primary PCI (PPCI), late PCI (after 48 hours from the disease onset), and PCI after thrombolytic therapy. Different types of PCI in STEMI have different benefits. Current guidelines substantiate absolute indications for stenting with the highest level of evidence for 12-hour PPCI, rescue PCI, and routine early PCI after thrombolytic therapy. At the same time, the priority role in reperfusion in STEMI is assigned to 12-hour PPCI. That is why this indicator is a target in the European Stent for Life (SFL) initiative — the national/regional indicator of 12-hour PPCI should be 70% or higher of the number of patients hospitalized with STEMI.