We have journeyed far.

The article by Goldberg and colleagues found in this issue is a meticulous history of the changes in incidence and in-hospital and long term case fatality rates of myocardial infarction (MI) for a defined New England community from 1975 to 1995 (1). The authors suggest that there is a decline in the incidence of acute MI as well as in the short term and one-year mortality in survivors postdischarge. In the current era of thrombolysis, polypharmacy and evershorter hospital stays with tighter allocation of resources, it is easy to forget how far we have come in the treatment of MI. It is equally easy, however, to envision where we should be in the new millennium. Nonetheless, Goldberg et al. invite us to recall the advances made in the treatment of the acute MI from 1975 to the present and to encourage reflection on future directions (1).