[ST-elevation myocardial infarction: reperfusion strategy based on the results from large clinical trials].

The efficacy of reperfusion therapy, both pharmacological and mechanical, in patients with ST-elevation myocardial infarction (STEMI) is time-dependent. The relation is closer the earlier we are from symptom onset and is valid for thrombolysis within 6h and for primary angioplasty till to at least the twelfth hour. Benefits of reperfusion bring to an advantage both in terms of myocardial salvage and left ventricular systolic function and in terms of quality of life and long-term survival. Although mortality and morbidity of STEMI patients have been greatly reduced in the last 20 years, the need for guideline revision and implementation remains urgent, mostly because mortality of real-world STEMI patients keeps to be always much higher compared to what reported in big randomized controlled trials. The most important indications from big trials and guidelines regarding both pharmacological and non-pharmacological reperfusion strategy in STEMI patients are discussed.