A study that was done before the widespread use of troponin only measurements for ACS (and certainly before high sensitively trop  EVER EXISTED), a trial that took place before the first statin was even FDA approved,  a trial that had no idea what DAPT was and took place PRIOR to the publication of the trial that would ultimately make aspirin post MI a standard of care, a trial that existed before a standard 90 minute door to balloon time.

As a reminder this trial (ISIS) didn’t demonstrate a huge mortality benefit despite all of the things that were missing from it that are now considered standard of care. The mortality number needed to treat was 143 (13.3% vs 14.0%) 


https://www.nejm.org/doi/abs/10.1056/NEJMoa2401479