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  • Spontaneous clinical syndrome related to atherosclerotic plaque rupture, ulceration, fissuring, erosion, or dissection, with resulting intraluminal thrombus, and leading to decreased myocardial blood flow or distal platelet emboli with ensuing myocyte necrosis. This classification requires a) detection of a rise and/or fall of cardiac biomarker values [preferably cardiac troponin (cTn)] with at least one value greater than 99th percentile of the upper reference limit (URL) and b) at least one of the following: symptoms of myocardial ischemia; new or presumed new significant ST-segment-T wave (ST-T) changes or new left bundle branch block (LBBB) on the ECG; development of pathological Q waves on the ECG; imaging evidence of new loss of viable myocardium or new regional wall motion abnormality; identification of an intracoronary thrombus by angiography or autopsy. (Universal definition of myocardial infarction, Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction, Eur Heart J (2007) 28 (20): 2525-2538.)
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