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Trials in the United States have enrolled patients with out\u2010of\u2010hospital cardiac arrest under exception from informed consent (EFIC). However, AMI\u2010CS has a longer therapeutic window to initiate treatment than out\u2010of\u2010hospital cardiac arrest, and more patients or their representatives can engage in treatment decisions. We provide a rationale for how a trial enrolling patients with AMI\u2010CS could qualify for conduct using EFIC by meeting each criterion specified in US human subject regulations. AMI\u2010CS is a life\u2010threatening situation, available treatments are unsatisfactory, and collection of valid evidence is necessary. Obtaining informed consent is often not feasible, and trial participation could benefit subjects. Only enrolling consented patients is impracticable and could reduce the study's generalizability. We propose a therapeutic window of 30\u2009minutes within the study intervention must be initiated, with consent sought within 15\u2009minutes, respecting any refusal or objection to enrollment, and otherwise enrollment under EFIC. A trial could enroll patients with AMI\u2010CS under EFIC and can involve both patients and their representatives. 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