Background Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy for ST-elevation myocardial infarction (STEMI), but most patients do not arrive at a PCI facility within the recommended 90-minute of first medical contact (FMC).In Chinese context pharmacoinvasive therapy might be a more practical solution.To provide more definitive evidence for the efficacy and safety of pharmacoinvasive strategy, we designed the Early MYO(Early Routine Catheterisation or Rescue Coronary Intervention after rt-PA vs.PPCI in STEMI) Trial, an open-label,prospective, non-inferiority, multicentre randomized study of STEMI patients to compare pharmacoinvasive strategy with PPCI on myocardial tissue-level reperfusion in STEMI.We present pilot study results in 87 consecutive STEMI patients recruited at the Renji Hospital for the Early MYO Trial.