ACLS ProMed Practice Test

Which statement concerning PCI is true?

PCI is preferred in patients with contraindications to fibrinolytics and only if it can be performed within 90 minutes of first medical contact by a skilled provider. PCI should be used in all acute coronary syndrome patients regardless of time window. PCI is never recommended if fibrinolytics can be given. PCI is preferred only for non-ST elevation ACS.

Correct Answer:

PCI is preferred in patients with contraindications to fibrinolytics and only if it can be performed within 90 minutes of first medical contact by a skilled provider.

Explanation:

In STEMI care, restoring blood flow quickly is the priority. If fibrinolytics are contraindicated, primary PCI is the preferred reperfusion method, provided it can be done promptly—ideally within about 90 minutes of first medical contact and by a skilled interventional team at an experienced facility. This approach offers mechanical revascularization with higher success rates and tends to have better outcomes, including lower mortality and fewer bleeding complications, compared with thrombolysis when the procedure can be completed in time. If PCI cannot be performed within that window, fibrinolysis may be considered if there are no contraindications, but the emphasis remains on achieving rapid reperfusion via PCI when feasible.

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