ABSTRACT

Introduction Acute coronary syndromes are a frequent cause of hospital admissions in industrialized nations. In the United States alone, acute coronary syndromes and myocardial infarction account for over 1.5 million hospital admissions annually.1

These syndromes share a common pathophysiology: a cholesterol-rich atherosclerotic plaque suddenly ruptures, triggering the formation of thrombus which further compromises coronary flow.2-5 Depending on the size of the thrombus, collateral flow, and the intrinsic fibrinolytic system, a spectrum of clinical presentations may ensue, including minimal or no symptoms, unstable or accelerated angina pectoris, myocardial infarction or even sudden death. Thrombotic lesions present a challenge for the interventional cardiologist as percutaneous treatment is associated with an increased complication rate such as abrupt occlusion, emergency bypass surgery, and death.6,7 Thrombotic lesions also appear to play an important role in restenosis.8,9