Coronary atherosclerosis and thrombosis underlying acute myocardial infarction.

Autopsy and clinical studies indicate that coronary thrombosis plays a key role in the development of acute transmural myocardial infarction and possibly in unstable angina and sudden cardiac death. The pathogenesis of coronary thrombosis is complex. It involves the dynamic interplay among the atherosclerotic arterial wall, vasomotor influences, cellular and humoral mediators, and the blood coagulation pathways.