Effectiveness, safety, moderation, complementary, network, consensus, strategy and evaluation are the key words in the therapeutic management of acute myocardial infarction. They focus the development of pharmacological and interventional tools of recanalisation, and the decisions for those who use them. In order to cover a condition for which the patient and doctor alike choose neither time nor place, they lead to linking methods and disciplines together for a united approach. They take account of practice in order to adapt scientific data to the realities of exercise, to justify the given means, and to propose clear, realistic and useful management guidelines to first contact doctors. They deliver the best to the greatest number of patients.