In the United States cardiovascular disease is the leading cause of and is responsible for 26% of deaths each year. Half of the deaths due to heart disease in 2006 were women. In 2009, the Center for Disease Control (CDC) estimated that 785,000 Americans had a new myocardial infarction and about 470,000 had a recurrent attack. Nearly 400,000 Americans will die of CHD in 2010. The cost of heart disease in terms of health care services, medications, and lost productivity for 2010 has been estimated at $316.4 billion. The current therapeutic guidelines for the treatment of ST elevation myocardial infarction are reviewed from a historical perspective, and the scientific evidence behind such guidelines is systematically analyzed.