Survivors of STEMI with indicators of intermediate or high risk and those with recurrent ischemia or mechanical compli- cations should be considered for coronary angiography and revascularization. In addition, when STEMI is suspected to have occurred by a mechanism other than thrombotic occlu- sion at the site of an atherosclerotic plaque, coronary angiog- raphy may be reasonable to provide diagnostic information and to direct specific therapy. Routine referral for angiography of patients after fibrinolytic therapy is discussed in Section 5.3. Coronary angiography in patients with evidence of failed reperfusion or reocclusion should be performed as soon as 6.2. PCI of an Infarct Artery in Patients Who Initially Were Managed With Fibrinolysis or Who Did Not Receive Reperfusion Therapy: Recommendations See Table 10 for a summary of recommendations from this section. Class I 1. PCI of an anatomically significant stenosis in the infarct artery should be performed in patients with suitable anatomy and any of the following: a. Cardiogenic shock or acute severe HF354 (Level of Evidence: B); b. Intermediate- or high-risk findings on predis- charge noninvasive ischemia testing232,233 (Level of Evidence: C); or c. Myocardial ischemia that is spontaneous or pro- voked by minimal exertion during hospitalization. (Level of Evidence: C) Table 9. 