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Acute coronary syndrome (ACS) encompasses a spectrum of clinical entities, ranging from unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) to ST-elevation myocardial infarction (STEMI). This book analyzes new research on the diagnosis and management of ACS. The first chapter reviews ethnic and gender differences in the diagnosis, risk factors and management of a multiethnic population in Malaysia. Chapter Two summarizes data from available studies conducted over the past last 30 years about pharmacologic reperfusion therapy including comparison with primary angioplasty. Chapter Three discusses the up-to-date available studies that have investigated consent in cardiology.

Get the tools and knowledge you need for effective diagnosis, evaluation, and management of patients with acute myocardial infarction. Myocardial Infarction: A Companion to Braunwald's Heart Disease, by David A. Morrow, MD, is a comprehensive, hands-on resource that provides practical guidance from a name you trust. Concise and easy to use, this text explores the most recent tools for diagnosis and therapeutic decision-making, as well as the full range of available management strategies, providing outcomes data for each strategy. Myocardial Infarction also includes regular updates with late-breaking clinical trials, reviews of important new articles, and the latest guidance on clinical practice, all selected and masterfully edited by Dr. Eugene Braunwald. Provides thorough discussions of ECG, established and emerging biochemical markers, angiography, nuclear cardiology, echocardiography, and cardiac MRI and CT. Features an extensive treatment section that covers the latest drugs and most recent clinical trials of antiplatelet therapy, coronary revascularization, gene therapy, and approaches to reperfusion injury and ventricular remodeling. Discusses special considerations for the evaluation of acute coronary syndromes in the emergency department, and use of advanced technologies in cardiac critical care. Covers key topics such as in-hospital complications, cardiogenic shock, transitions to post-discharge care, and cardiac rehabilitation. Includes Clinical Practice/Controversy chapters that highlight management-focused, practical topics covering expert approaches for areas of uncertainty. Offers guidance on the management of special populations. Consult this title on your favorite e-reader for access to regularly added update content, to conduct rapid searches, and adjust font sizes for optimal readability.

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality. The almost exclusive cause of acute coronary syndromes (ACS), including unstable angina, AMI with or without ST-segment elevation, and sudden cardiac death is atherothrombosis. This book discusses risk factors, emergency management and long-term health outcomes of myocardial infarctions. Some of the topics discussed include MI and cardiogenic shock; risk of MI in the pathophysiology and treatment of prostatic diseases; albuminuria; essential roles of monocytes/macrophages in ACI; and management of unstable angina/non-ST segment MI.

The past 50 years have witnessed a breathtaking evolution in the approaches to the patient with an acute ST elevation myocardial infarction. In the 1960s, the now commonplace cardiac intensive care unit was but a nascent idea. Without much to offer the patient but weeks of absolute bedrest, substantial morbidity and high rates of mortality were the norm. Just 30 years ago, seminal discoveries by DeWood and colleagues suggested that the culprit was plaque rupture with thrombosis, not progressive luminal compromise. Subsequent fibrinolyt- based strategies resulted in a halving of the mortality of acute myocardial infarction. With the introduction of balloon angioplasty in the late 1970s, a few interventional cardiologists braved the question: why not perform emergency angioplasty as a primary reperfusion strategy? Indeed, reports of successful reperfusion via balloon angioplasty appeared (mostly in local newspapers) as early as 1980. Despite being thought of as heretical by mainstream cardiology, these pioneers nonetheless persevered, proving the benefit of ‘‘state-of-the-art''balloon angioplasty compared with ‘‘state-of-t- art''thrombolytic therapy in a series of landmark trials published in the New England Journal of Medicine in March of 1993. Publication of the first edition of Primary Angioplasty in Acute Myocardial Infarction in 2002 to some extent anticipated the widespread acceptance of primary percutaneous coronary intervention as the standard of care. Since then, in all respects, the evolution of emergency percutaneous revascularization has only accelerated. The universal replacement of balloon angioplasty with stent implantation was clearly one key.

Il volume fornisce una rivisitazione schematica ma, nello stesso tempo, completa e aggiornata della problematica relativa alla Sindrome Coronarica Acuta, alla luce di quanto pubblicato negli ultimi dieci anni. Premettendo i concetti di elettrocardiografia e di istofisiopatologia, viene affrontata la riclassificazione nosologica della patologia coronarica acuta derivata dall'introduzione nella pratica clinica dei nuovi marker di necrosi miocardica, sottolineando anche la necessità che il Medico valuti il rischio intrinseco alla malattia attraverso il calcolo di specifici punteggi proposti dagli studi clinici. Si analizzano, quindi, i diversi percorsi terapeutici che devono essere posti in essere, sia quelli puramente farmacologici, sia quelli più'aggressivi'. Ampio spazio viene dato alle modalità d'impiego dei nuovi trattamenti antitrombotici e alle modalitö di scelta fra terapia farmacologica e approccio invasivo mediante coronarografia e angioplastica.

In this second edition of his highly acclaimed book, Christopher P. Cannon, MD, and a team of preeminent clinical investigators have thoroughly revised and expanded every chapter to reflect the recent explosion of clinical trials on the management of acute coronary syndromes (ACS). This includes: the newer tests, such as C reactive protein; a multimarker approach to diagnosis and risk stratification; new antiplatelet agents; and combinations of thrombolytic-antithrombotic regimens. Also discussed are the latest developments in interventional cardiology, the use of cost-effectiveness in clinical trials to choose appropriate therapies, and the employment of critical pathways analysis to improve compliance with evidence-based medicine and guideline recommendations.

Leading investigators and highly experienced clinicians collect and summarize the world's literature and augment this with practical wisdom concerning this critically important form of care, including its technical, professional, and administrative aspects. Among the topics covered are the technique and technology of direct angioplasty, patient selection, regulatory issues, performance metrics, clinical trials and outcomes, adjunctive pharmacology, economics, and implications for the health care system. The practicing cardiologist will appreciate the many useful how-to tips and pointers; the cardiology fellow will value the a-to-z approach that addresses all critical issues; the administrator will learn all the details of creating, maintaining, evaluating, and justifying a successful program.

The Pathophysiology and Pharmacotherapy of Myocardial Infarction deals with the advances in the pathophysiology and pharmacotherapy of acute myocardial infarction and related complications. This book covers two major consequences—cardiac muscle dysfunction and cardiac electrical dysfunction. This text begins by reviewing the controversy surrounding the pathogenetic mechanisms of atheroma formation and its potential reversibility, including the status of coronary risk factors and benefits of primary prevention. The pathophysiologic mechanisms of pump failure and the current approach to its management are then deliberated, followed by a discussion on the rational use of vasodilators in post-infarction heart failure and pharmacotherapy of cardiogenic shock. The rationale for the interest in the role of coronary vasospasm and thrombolytic therapy for acute myocardial infarction is also covered. This publication concludes by reviewing the approaches for the management of post-infarction ventricular tachyarrhythmias and concept of secondary prevention of sudden cardiac death. This compilation is valuable to medical students, primary care physicians, and cardiovascular specialists.