Inclusion Criteria:

Electrocardiographic inclusion criteria: (baseline 12-lead ECG recorded at 25 mm/second upon arrival at investigational center)

• STEMI within 12 hours of symptom onset, with ≥ 2 mm ST segment elevation in two or more leads and minimum ≥ 3 mm ST segment elevation in one lead.

Angiographic inclusion criteria after crossing with guidewire:

• IRA is a native coronary artery; and,
• Reference vessel diameter 2.5 - 4.0 mm; and,
• TIMI 0 or 1 flow with any TIMI thrombus grade; or,
• TIMI 2 or 3 flow with TIMI thrombus grade 3 or greater

Exclusion Criteria:

• Patient unwilling or unable to give informed consent
• Previous MI in the distribution of the current IRA
• Previous CABG

• Contraindications to PCI

  • allergy(s) to intended study medications
  • contraindicated for stent implantation
• Active bleeding or coagulopathy
• Patient in cardiogenic shock (<90mmHg SBP and/or requiring IABP or vasopressors)
• Known left ventricular ejection fraction (EF) <30%
• Fibrinolytic administered before PCI
• Renal insufficiency (creatinine >2.0mg/dl)
• Current vitamin K antagonist therapy or known INR >1.5
• Known thrombocytopenia - platelets <100,000 cell count
• Patient has Left Bundle Branch Block (LBBB) or pacemaker rhythm
• Known history of hemorrhagic stroke (CVA or TIA) <2 years before screening
• Known or suspected pregnancy
• Current cancer disease
• Comorbidity where survival is anticipated to be <1 year.
• No future patient cooperation expected
• Patient is participating in another clinical study
• Patient <18 years of age