The priority of early therapy is to establish reperfusion in the affected myocardium. Current alternatives to achieve this goal are pharmacological (thrombolysis) or mechanical (primary percutaneous coronary intervention (PPCI)).

There is a non-linear relationship between time delay and outcome following thrombolysis, with much greater benefit in patients with short symptom onset to treatment
times [9]. Up to 60 deaths per thousand treated are prevented if thrombolysis is delivered within one hour of onset of symptoms. The clear relationship between delay to treatment and reduced benefit has been the rationale for the implementation of pre-hospital thrombolysis (PHT).