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Pharmacoinvasive strategy has been proposed as a therapeutic option in patients with STEMI when timely PPCI is not feasible. However, pharmacoinvasive strategy has potential delay between clinical patency and complete myocardial perfusion. The optimal reperfusion strategy for STEMI patients with anticipated PPCI delay according to current practice is uncertain. OPTIMAL\u2010REPERFUSION is an investigator\u2010initiated, prospective, multicenter, randomized, open\u2010label, superiority trial with blinded evaluation of outcomes. A total of 632 STEMI patients presenting within 6 hours after symptom onset and with an expected time of first medical contact to percutaneous coronary intervention (PCI) \u2265120\u2009minute will be randomized to a reduced\u2010dose facilitated PCI strategy (reduced\u2010dose fibrinolysis combined with simultaneous transfer for immediate invasive therapy with a time interval between fibrinolysis to PCI\u2009&lt;\u20093 hours) or to standard pharmacoinvasive treatment. The primary endpoint is the composite of death, reinfarction, refractory ischemia, congestive heart failure, or cardiogenic shock at 30\u2010days. Enrollment of the first patient is planned in March 2021. The recruitment is anticipated to last for 12 to 18\u2009months and to complete in September 2023 with 1 year follow\u2010up. The OPTIMAL\u2010REPERFUSION trial will help determine whether reduced\u2010dose facilitated PCI strategy improves clinical outcomes in patients with STEMI and anticipated PPCI delay. This study is registered with the ClinicalTrials.gov (NCT04752345).<\/jats:p>","DOI":"10.1002\/clc.23582","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T05:14:02Z","timestamp":1614316442000},"page":"455-462","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Rationale and design of the <scp>OPTIMAL\u2010REPERFUSION<\/scp> trial: A prospective randomized multi\u2010center clinical trial comparing different fibrinolysis\u2010transfer percutaneous coronary intervention strategies in acute <scp>ST<\/scp>\u2010segment elevation myocardial infarction"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-0854","authenticated-orcid":false,"given":"Zhongxiu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Cardiology West China Hospital of Sichuan University  Chengdu 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