The reperfusion era. Strategies for establishing or maintaining coronary patency. Journal   Cardiology clinics. Citation   Cardiol Clin. 20(1):137-57, ix Publication date   2002 Feb Authors   Field JM Investigators   John M. Field MeSH headings   Angina, Unstable Myocardial Infarction Myocardial Revascularization MeSH qualifiers   therapy methods Abstract   Only 3 decades ago, controversy existed over the origin of the thrombus that occluded coronary arteries during myocardial infarction (MI). Then, the acute clinical angiographic studies of DeWood butterssed new pathological and experimental evidence that the thrombus was the proximate cause of MI and unstable angina. The remaining years of the 20th century saw an explosion of knowledge delineating a spectrum of related disorders now collectively called acute coronary syndromes (ACS). The clinician managing patients is confronted with an array of evidence as more than 75,000 patients worldwide have been randomized to clinical trials in ACS. This article reviews key pathophysiological concepts, presents an initial strategy for triage of patients, and summarizes evidence-based medicine guiding therapy for acute coronary lesions. Medline ID   21835053