Patients presenting within 12 hours from the onset of symptoms with STEMI

Informed, written consent

Age < 18 years or Age > 75 years

Active bleeding

bleeding diathesis

coagulopathy

Increased risk of bradycardiac events

History of gastrointestinal bleeding <2 months

History of genitourinary bleeding <2 months

Major surgery in the last 6 weeks

History of intracranial bleeding or structural abnormalities

Suspected aortic dissection

Administration in the week before the index event of clopidogrel

Administration in the week before the index event of ticlopidine

Administration in the week before the index event of prasugrel

Administration in the week before the index event of ticagrelor

Administration in the week before the index event of thrombolytics

Administration in the week before the index event of bivalirudin

Administration in the week before the index event of low-molecular weight heparin

Administration in the week before the index event of fondaparinux

Concomitant oral or IV therapy with strong CYP3A inhibitors

Concomitant oral or IV therapy with strong CYP3A inducers

Known relevant hematological deviations: Hb <10 g/dl

Known relevant hematological deviations: Thrombi. <100x10^9/l

Use of coumadin derivatives within the last 7 days

Known severe liver disease

severe renal failure

Known allergy to the study medications

Pregnancy