Insights into the pathogenesis of acute ischemic syndromes

We are on the threshold of an exciting era in the treatment of coronary disease in which the critical role of thrombosis in the production of the major life-threatening clinical syndromes has become recognized. A fuller understanding of the importance of the role of blood flow, of thrombogenic substrate exposure by plaque rupture, and the mechanism of the latter is developing. The continuing manipulation of the hemostatic system by known antithrombotic agents, as well as by new antithrombotic drugs with a different locus of attack (i.e., peptide-receptor blockers and monoclonal antibodies), together with the results of ongoing clinical trials, promise to improve the future for our patients until the goal of primary prevention can eliminate the disease.