Subjects with anterior acute STEMI who receive an IABC before primary PCI will have decreased MI size.

Post clearance device study in which subjects with acute MI will be randomized 1:1 to either receive IAB or to receive standard of care without IAB before mechanical reperfusion. Subjects will be followed throughout their hospital stay and at 30 days.

Inclusion Criteria:

• Able to understand and sign an ICF
• ≥ 18 and ≤ 90 years of age
• General good health, in the opinion of the investigator
• ST elevation of 2mm in 2 contiguous anterior leads or ≥ 4mm total in anterior leads
• Scheduled for PCI < 6 hours from onset of symptoms of MI

Exclusion Criteria:

• Known contraindication to MRI
• Prior thrombolytic therapy during the index event
• Known history of MI
• Known severe aortic insufficiency
• Known aortic aneurysm
• Known severe calcific aorta-iliac disease or peripheral vascular disease
• Experiencing cardiac shock
• Known end-stage renal disease
• Weight >400 lbs. or height <4 ft.