The management of the acute coronary syndromes (ACS), made of the acute myocardial infarction (ACS with ST-segment elevation) and the unstable angina/non-Q wave myocardial infarction (ACS without ST-segment elevation), are a major source of research. BNP, myeloperaxidase or CD401 as biological markers of cardiac injuries and technological devices (intracoronary thermotools under investigations. On the therapeutic point of view, the early invasive strategy is confirmed. Therefore, the optimalization of the adjuvant treatment was broadly investigated. Ximelagatran, a new oral anticoagulant, should find a place in the management of our unstable patient based on recent studies. Finally, stem-cell transplantation after myocardial infarction will be probably a new treatment strategy. The first human study is just finished, demonstrating the benefit of this approach. The acute coronary syndromes are a major source of research based on the proof of today and on the wishes for tomorrow.