Abstract
Diagnosis and treatment of acute myocardial infarction have been developed in the past 50 years. Since the 1970's, the concept of unstable angina has been advocated to stratify the high-risk group of impending myocardial infarction. In the 1980's and 1990's, the new concept i. e., “acute coronary syndrome” was proposed. The mechanisms of acute coronary ischemic events have been clarified. In 2000, the definition of acute myocardial infarction was revised, and the new risk stratification was recommended to detect the myocardial damage more rapidly by using several novel markers, e.g., troponin T and troponin I. With regard to the treatment, the main therapeutic goal of acute myocardial infarction in the 1960's was the prevention of life-threating arrhythmias. Selective coronary angiography and coronary bypass graft surgery spread in the 1970's, and the era of thrombolysis was launched in the 1980's. Percutaneous transluminal coronary angioplasty (PTCA) and stenting were established to be safe and cost effective therapies by large randomized studies in the 1990's. New devices, such as directional coronary atherectomy and rotablator were now widely used. On the other hand, several minimally invasive surgical techniques have been established.
