Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction

Inclusion Criteria: * Must have clinical symptoms consistent with AMI (e.g., angina or anginal equivalent)lasting \>20 minutes but \<12 hours in duration; * ST-segment elevation of \>1 mm in \>2 contiguous leads, or (presumably new) left bundle branch block, or true posterior MI with ST depression of \>1 mm in \>2 contiguous anterior leads; * The patient or guardian agrees to the study protocol and the schedule of clinical and angiographic follow-up, and provides informed, written consent. Exclusion Criteria: * The patient has a known hypersensitivity or contraindication to any of the following medications: * Heparin, pork or pork products * Both abciximab and eptifibatide * Aspirin * Both Clopidogrel and Ticlopidine * Bivalirudin * Paclitaxel or Taxol * The polymer components of the TAXUS™ stent (SIBS) * Stainless steel and/or * Contrast media; * Prior administration of thrombolytic therapy, bivalirudin, GP IIb/IIIa inhibitors, low molecular weight heparin or fondaparinux for this admission. Patients receiving prior unfractionated heparin may be enrolled, and treated per randomization; * Current use of coumadin; * Systemic (intravenous) Paclitaxel or Taxol use within 12 months; * Female of childbearing potential, unless a recent pregnancy test is negative, who possibly plans to become pregnant any time after enrollment into this study; * History of bleeding diathesis or known coagulopathy (including heparin-induced thrombocytopenia), or will refuse blood transfusions; * History of intra-cerebral mass, aneurysm, arteriovenous malformation, or hemorrhagic stroke; * Stroke or transient ischemic attack within the past 6 months, or any permanent residual neurologic defect; * Gastrointestinal or genitourinary bleeding within the last 2 months, or major surgery within six weeks; * Recent history or known current platelet count \<100,000 cells/mm3 or Hgb \<10 g/dL; * Extensive peripheral vascular disease, such that emergent angiography and intervention in the opinion of the investigator is likely to be difficult or complicated; * An elective surgical procedure is planned that would necessitate interruption of thienopyridines during the first six months post enrollment; * Non-cardiac co-morbid conditions are present with life expectancy \<1 year or that may result in protocol non-compliance; * Patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period; * Previous enrollment in this trial; * Patients who underwent coronary stent implantation within the past 30 days.