Which statement best summarizes boards’ preferred reperfusion approach for ACS when feasible?

• A. PCI is the preferred reperfusion strategy when feasible
• B. Thrombolysis is always preferred
• C. CABG is first-line for all ACS
• D. Medical therapy alone is sufficient

Answer: (A)

In ACS, the aim is to rapidly restore blood flow to the affected area of the heart. When feasible, primary PCI is the preferred reperfusion approach because it mechanically opens the blocked artery and restores perfusion more reliably than clot-busting drugs. This leads to better survival, fewer reinfarctions, and a lower risk of bleeding complications compared with thrombolysis, and it avoids the limitations of medication-only approaches. If timely PCI isn’t available, thrombolytic therapy serves as an alternative, but it carries higher bleeding risk and isnues less consistent reperfusion. CABG isn’t the first-line option in the acute setting for most ACS patients; it’s typically reserved for specific anatomical situations or after failed PCI. Medical therapy alone does not resolve the artery occlusion in a STEMI and is insufficient as sole treatment.