Primary PCI: false positives versus false negatives

Primary percutaneous coronary intervention (PCI) performed within 12 hours after onset of symptoms in acute ST-elevation myocardial infarction (STEMI) is the currently recommended therapy in the guidelines of the European Society of Cardiology.1 The basis of these recommendations is an array of clinical trials comparing PCI with thrombolysis on short-term as well as long-term follow-up.2 Initially and intuitively larger STEMIs in younger patients were eligible for this therapy, but increasingly also smaller infarcts and older patients have proven to benefit from primary PCI.3 Typically, in centres providing the service of primary PCI in the Netherlands, about a third of the total number of PCIs is now for STEMI.