First-in-Human study to assess the CoFI™ device related safety and the feasibility of the diagnostic and the therapeutic sequence as well as the correlation between the dynamic microvascular resistance (dMVR) and microvascular obstruction (MVO) as measured by MRI in patients presenting with acute ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).

Major Inclusion Criteria:

• Patients 18 years of age or older presenting with ST-elevation myocardial infarction in the left anterior descending artery (LAD) undergoing primary percutaneous coronary intervention.
• Competent mental condition to provide signed and dated ethics committee approved study consent prior to study related procedures
• Eligible for prasugrel, ticagrelor, cangrelor, tirofiban, UFH and GP IIb/IIIa inhibitors
• Referred for primary PCI within 5 hours of symptom onset with evidence of continuing ischemia and symptom to balloon time not exceeding 6 hours

Major Exclusion Criteria:

• Unconsciousness
• Previous bypass graft surgery
• Contraindication to CMRI
• Recent or current major bleeding within 30 days prior to intervention
• Recent major surgery within 30 days prior to intervention
• End-stage heart failure with inotrope support and/or consideration for LVAD or heart transplant
• Transient ischemic attack or stroke within 30 days prior to intervention
• Pregnant or females of childbearing potential