One of the leading experts in the field and a stellar cast of contributors provide all of the scientific and clinical information needed to facilitate rapid evaluation and immediate management of acute coronary syndromes using today's full range of strategies?from pharmaceutical approaches to revascularization. Readers will also find coverage of special considerations for specific populations and care settings, as well as the recent guidelines from the AHA/ACC and ESC Task Forces for the management of these challenging, life-threatening syndromes.
Examines the molecular mechanisms of acute coronary syndromes, inflammation and immunity.
Explains the function of the endothelium and its role in atherosclerosis.
Explores all of the current methods of diagnosis and provides outcomes data for each modality, encompassing ECG, biochemical markers, angiography, nuclear cardiology, echocardiography, MRI, CT, and more.
Covers today's full range of available management strategies, including antiplatelet therapy, gene therapy, and pharmaceutical approaches to inflammation, revascularization, and more.
Discusses special considerations for the care of acute coronary syndromes in the ED and CCU.
Offers guidance on the management of special populations and chronic patients.
Includes guidelines for management of acute coronary syndromes from the AHA/ACC and ESC Task Forces, with commentary from Eugene Braunwald, MD and Michel Bertrand, MD.
Foreword
xiii
Preface
xv
Section 1
Acute Coronary Syndromes and Clinical Practice
1
1
From Pre-infarction Angina to Acute Coronary Syndromes: A Historical Perspective
1
2
Acute Coronary Syndromes: National and International Dimensions of the Problem
10
3
An Epidemiological Perspective: Society, Environment, Risk Factors, and Genetics
15
4
Natural History and Prognosis
49
Section 2
Pathophysiology
67
5
Pathology of Stable and Acute Coronary Syndromes
67
6
Molecular Mechanisms of the Acute Coronary Syndromes: The Roles of Inflammation and Immunity
80
7
The Role of Infection
88
8
Triggers to Acute Coronary Syndromes
108
9
Novel Risk Factors in Acute Coronary Syndromes
119
10
What Cardiologists Need to Know on Depression in Acute Coronary Syndromes
131
Section 3
Diagnosis
145
11
Clinical Recognition of Acute Coronary Syndromes
145
12
Acute Coronary Syndromes in the Emergency Department: Diagnosis, Risk Stratification, and Management
152
13
Electrocardiography, ECG Monitoring, and Provocative Stress Testing in Acute Coronary Syndromes
168
14
Biochemical Markers of Myocardial Necrosis
187
15
Markers of a Thrombotic State
197
16
Markers of Inflammation
209
17
Coronary Angiography and the Culprit Lesion in Acute Coronary Syndromes
226
18
Echocardiography in Acute Coronary Syndromes
250
19
Nuclear Cardiology Techniques in Acute Coronary Syndromes
269
20
Computed Tomography in Coronary Artery Disease
285
21
Emerging Diagnostic Procedures for the Vulnerable Plaque
294
22
Risk Stratification in Non-ST-Segment Elevation Acute Coronary Syndromes
308
23
Continuous Risk Stratification
322
Section 4
Pharmacologic Management
331
24
Nitrates and Nitric Oxide Donors
331
25
[beta]-Blockers and Calcium Channel Blockers: Use in Acute Coronary Syndromes
341
26
ATP-Sensitive Potassium Channels, Adenosine, and Preconditioning
351
27
Metabolic Interventions
359
28
Antiplatelet Therapy
368
29
Anticoagulant Therapy
400
Section 5
Management Strategies
419
30
Acute Plaque Passivation and Endothelial Therapy
419
31
Anti-thrombotic Management
431
32
Treatment of Cardiovascular Inflammation
444
33
Myocardial Cell Protection in Acute Coronary Syndromes
453
Section 6
Revascularization
473
34
Revascularization in Acute Coronary Syndromes: Which Patients and When?
473
35
Advantages and Hazards of Early Revascularization
492
36
New Surgical and Percutaneous Revascularization Procedures
498
37
Pharmacologic Revascularization
515
38
The Patient with Disabling Angina Not Amenable to Revascularization Procedures
539
Section 7
Special Subgroups
553
39
The Elderly, Women, and Patients with Diabetes Mellitus
553
40
Coronary Artery Spasm
574
41
The Patient with Chest Pain Despite Normal Coronary Angiography
588
42
Cocaine and Other Environmental Causes of Acute Coronary Syndromes
594
Section 8
From the Acute Phase to the Chronic Phase
601
43
Control of Risk Factors
601
44
Dietary Intervention in Coronary Care Units and in Secondary Prevention
613
Section 9
Outlook to the Future
633
45
Perspective for Gene and Cell-Based Therapy
633
46
Cardiovascular Regeneration and Stem Cell Differentiation
649
47
Identifying the Vulnerable Plaque and the Vulnerable Patient
661
48
The Modern Coronary Care Unit
677
Section 10
Guidelines for Management
689
49
Guidelines of the European Society of Cardiology
689
50
ACC/AHA 2002 Guidelines Update for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction--Summary Article
709
Index
719