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Unifies acute coronary syndrome management under one mechanism; leaves open targeted therapies pending prospective validation.
Rupture of an atherosclerotic plaque, with or without superimposed thrombus formation and vasoconstriction, may be the common anatomic and pathogenetic denominator for unstable angina, myocardial infarction, and ischemic sudden death. Outcome seems to be determined by the suddenness of coronary occlusion, the degree of perfusion insufficiency, and—most important—the duration of ischemia.
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Stein et al. (1988) studied this question.
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