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[Comment] Primary angioplasty for STEMI: hard to improve upon

Primary angioplasty has substantially improved the clinical outcomes of patients with ST-elevation myocardial infarction (STEMI).1–3 Although the procedure was first done with balloon angioplasty only, without optimum antiplatelet therapy, results were impressive and showed a significant reduction in infarct size, improved left ventricular function, and decreases in short-term and long-term mortality. Since then, many studies have tried to improve outcome further. Routine stenting, even with drug-eluting stents, reduced restenosis but did not improve infarct size or reduce mortality.