الفهرس 
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Abstract
Primary percutaneous coronary intervention is the preferred method of ST-elevation myocardial infarction treatment if it can be performed in a timely manner.
Increasing age and presence of co morbidities were recognized as critical factors in predicting clinical outcome in patients with STEMI. Co-morbidities leading to higher incidence of early mortality include existing coronary heart disease, diabetes mellitus, renal disease, peripheral vascular disease and HF.
The development of mechanical complications is associated with a significantly lowered short-term and long-term survival, since the primary percutaneous coronary intervention introduction as the principal reperfusion strategy following acute STEMI.
The total ischemic time, between symptom onset and provision of reperfusion therapy either starting fibrinolysis or mechanical reperfusion by PPCI is probably the most important factor. The aim is to provide optimal care while minimizing delays, in order to improve clinical outcomes.
The pre-hospital phase: STEMI systems of care based on networks of medical institutions connected by an efficient emergency medical service are pivotal. The first steps are devoted to minimize the patient’s delay in seeking care, rapidly dispatch a properly staffed and equipped ambulance to make the diagnosis on scene, deliver initial drug therapy and transport the patient to the most appropriate (not necessarily the closest) cardiac facility.