Puymirat E, et al. - Using data from 5 one-month French nationwide registries, researchers determined the impact of use or non-use of reperfusion therapy (primary percutaneous coronary intervention (pPCI) or fibrinolysis) on profile, management, and one-year outcomes in ST-segment-elevation myocardial infarction (STEMI) patients, by analyzing 20-year trends. Overall 8579 STEMI patients (67% with and 33% without reperfusion therapy) who sought admission to cardiac intensive care units in France were included. From 1995 to 2015, an increase from 49% to 82%, respectively, in the use of reperfusion therapy, was reported, with a shift from fibrinolysis (37.5% to 6%) to pPCI (12% to 76%). Findings revealed a continuous decline in one-year mortality in STEMI patients, both associated with increased use of reperfusion therapy and progress in overall patient management. Since 2010, a stable mortality has been reported in patients with reperfusion therapy, while a continuous decline in mortality has been seen in patients without reperfusion therapy.