# CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2026

## TL;DR

This paper presents an updated expert consensus on primary PCI for treating acute coronary syndromes in 2026, incorporating new evidence and technology.

## Contribution

The paper provides a 2026 updated expert consensus on primary PCI for ACS, integrating recent clinical evidence and technological advancements.

## Key findings

- Primary PCI remains the standard of care for STEMI in Japan.
- The consensus document incorporates new clinical evidence and technological advances.
- The 2026 version updates prior guidelines from 2018, 2022, and 2024.

## Abstract

Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018 and updated in 2022 (Ozaki et al. in Cardiovasc Interv Ther 33:178–203, 2018), (Ozaki et al. in Cardiovasc Interv Ther 37:1–34, 2022). Following the publication of the 2023 European Society of Cardiology (ESC) Guidelines for the management of acute coronary syndromes, the CVIT Task Force released another revised version in 2024 (Ozaki et al. in Cardiovasc Interv Ther 39:335–375, 2024). In light of new clinical evidence and technological advances that have emerged since then, the Task Force now proposes an updated expert consensus document for the management of ACS focusing on procedural aspects of primary PCI in 2026 version.