Abstract: @@ Acute coronary syndromes (ACS) consist of Aunstable angina pectoris, non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction. The pathogenic mechanism of ACS is most often based on thrombosis secondary to plaque rupture in atherosclerosis (AS). Recent studies indicate that immune and inflammatory responses are associated with the plaque instability in AS.1 Here we review molecular and cellular immunologic processes linked to initiation and progression of ACS and discuss potential applications of immunosuppressant therapy and the possible beneficial immune effects of some cardiovascular medicines used commonly in ACS.