Plaque rupture and intracoronary thrombus in nonculprit vessels: an eyewitness account.

ver the last 25 years, there has been enormous progress in nderstanding the pathogenesis of acute coronary synromes (ACS) and the pathobiology of atherosclerosis and therothrombosis. Nonocclusive, mural, or occlusive intraoronary thrombus (ICT) has been established as the cause f nearly all acute myocardial infarctions (AMIs), a majority f non–ST-segment elevation ACS, and a large proportion f patients with sudden cardiac death (SCD) (1,2). The therosclerotic process underlying ICT is usually either laque disruption (PD) or erosion (3). Plaque inflammation fuels the fires” of atherosclerosis contributing to plaque isruption and erosion, as well as to the initiation and rogression of the atherosclerotic process (4).