Three advisory groups of the Council for Myocardial Ischemia and Infarction regularly review current knowledge concerning the following clinical contexts: silent ischemia, acute intervention, and postmyocardial infarction. This article represents the most recent findings of each Advisory Group--the areas of agreement and those of disagreement. What is emphasized here is that ongoing research is critical to refining the therapeutic approach to ischemia and the postmyocardial infarction patient. What seems rational is the stratification of patients into risk groups--high and low--that dictate whether intervention should be aggressive or conservative.