A Contemporary Review of Myocardial Infarction with Emphasis on Clinical Trials and Therapeutic Approaches.

Myocardial infarction (MI), a major manifestation of coronary artery disease, remains a global health challenge despite significant advances in research and therapy. This review highlights current developments in diagnostic criteria, pathophysiology, treatment strategies, and emerging therapeutic targets. Type 1 MI, driven by atherosclerotic plaque rupture and thrombosis, continues to dominate, but growing recognition of type 2 MI and MINOCA (myocardial infarction with nonobstructive coronary arteries) underscores the need for refined diagnostic and therapeutic approaches. High-sensitivity cardiac troponins and advanced imaging have improved early detection, classification, and risk stratification. The management now emphasizes personalized, evidence-based care, including percutaneous coronary intervention or thrombosis, dual antiplatelet therapy, lipid-lowering agents, and cardioprotective drugs. Despite improved outcomes, challenges, such as late presentation, treatment disparities, recurrent events, and progression to heart failure, persist. A comprehensive literature search was conducted using electronic databases, such as Web of Science, Google Scholar, PubMed, SciFinder, Reaxys, and the Cochrane Library. By identifying persistent gaps, this work aimed to inform clinicians, researchers, and policymakers on innovative strategies for prevention, early detection, and optimal MI management.