[Progress in the diagnosis and treatment of acute coronary syndromes]

As the pathogenesis of acute coronary syndromes (ACS) has been well increasingly defined, there has been enormous progress in the diagnosis and treatment of ACS during the past 50 years. The previous terminology referring to the heterogeneity of the disease has shifted toward a unifying concept encompassing the wide spectrum of manifestations of ACS, subdivided for the purpose of therapeutic considerations into ST elevation myocardial infarction (MI), and non ST elevation ACS with or without cell necrosis (utilizing troponins), namely non ST elevation MI or unstable angina. The advent of coronary care units and the results of randomized clinical trials on reperfusion therapy, thrombolysis or percutaneous coronary intervention, and medical treatment with various pharmacological agents have substantially changed the therapeutic approach, and decreased in-hospital mortality.