A clinical case of ST-elevation acute myocardial infarction has been presented. Apart from standard drug therapy, percutaneous coronary reperfusion with manual aspiration of thrombi was performed with further histological examination of the obtained materials. Clot formation appeared long before the development of acute myocardial infarction in this patient. It was also demonstrated an important role of inflammation at the initial step of thrombus formation in this case. But earlier coronary arteries were affected by xenobiotics.