Many readers of this site might have wondered , about a series of biased articles pulling down the superiority of pPCI in STEMI.
This French study (FAST-MI) throws stunning data from the real world. Initial Fibrinolysis* defeated pPCI in all aspects of coronary reperfusion !
*When we say fibrinolysis arm it means Pharmaco -Invasive approach .Today our brain is irreversibly conditioned to believe standalone fibrinolysis is forbidden in STEMI . (Which I strongly disagree!) I am sure, very soon another stunning study will unmask the truth about standalone fibrinolysis as well !
Final message
- The truth is , pPCI is really a superior modality in some of the complicated subsets of STEMI that too if performed fast.
- In all other situations Initial fibrinolysis will rule supreme !
- pPCI is not an Innovation for mass consumption!
- Hence, “the roof top call” for pPCI for every STEMI is nether desirable nor feasible.
Now, we have this evidence from France (Which was well known to us a decade ago) As always , truth takes time to arrive , while falsehood can come instantly !
In 2014 , after two decades of celebration of pPCI the flagship Circulation journal throws this Editorial !
Dr.S.Venkatesan MD 
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