In ACS, if PCI is feasible, which intervention is most likely to improve survival?

• A. Percutaneous Coronary Intervention
• B. Thrombolysis
• C. Beta-blocker therapy alone
• D. Coronary bypass surgery

Answer: (A)

Restoring blood flow quickly to the blocked artery is the most important factor for improving survival in acute coronary syndromes. When a primary PCI can be performed promptly, it provides the strongest mortality benefit because it immediately reopens the culprit vessel, salvages myocardium, reduces infarct size, and lowers the risk of reinfarction and arrhythmias. Thrombolysis is an alternative if PCI isn’t available soon enough, but it’s less effective at achieving complete reperfusion and carries higher bleeding and stroke risks. Medical therapy, including beta-blockers, helps prevent complications and reduces myocardial oxygen demand, but it does not by itself reopen the artery, so it doesn’t match the survival advantage of definitive reperfusion. Coronary bypass surgery has a role in selected cases, such as complex multivessel disease or failed PCI, but it is not the quickest intervention to improve survival when PCI is feasible.