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Angiographic observations in the early 1980s confirmed that acute coronary thrombosis was the proximate cause of acute myocardial infarction seminal studies that led to revolutionary treatments for the recanalization of occluded vessels. However, during the subsequent decades, the results of basic and clinical investigation have shown that the coronary clot is predominantly a secondary phenomenon; the true culprit in unstable ischemic heart disease is rupture of the underlying vulnerable atherosclerotic plaque.
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