The clinical efficacy of primary angioplasty for acute myocardial infarction was limited by recurrent myocardial ischaemia during hospital stay and restenosis in the months thereafter. The role of Renin Angiotesin System (RAS) in vessel healing after PTCA was studied. Two genetic susceptibility factors were studied. The insertion and/or deletion (I/D) polymorphism of ACE gene and A/C1166 C transversion of angentin II type I receptor gene. A total of 248 patients with acute MI during the time period for June 1997 till June 2003 were enrolled into this study. They included 176 M, 72 F, with a mean age of 51.5 + 12.4 (range 27 to 73 y). Mean admission time of 5.6 + 0.75 hrs (range 1.5 to 13 hrs) from the onset of chest pain. Among all studied pt, the primary intervention was successful in 233 patients (94%) and failed in only 15 patients (6%). The success goal was to open the infarct related artery. Primary intervention in the setting of acute MI can be safely and readily performed in well equipped centers with experienced teams. Primary PTCA in acute MI should be a priority option in well equipped centers with a special recommendation to abbreviate the time window of intervention as much as we can.