The management of non-ST segment elevation acute coronary syndromes (NSTE-ACS) has rapidly evolved over the last few years and many guidelines have been provided and already updated. This book is based on the latest ESC Guidelines and reports the current knowledge in NSTE-ACS, together with the most recent therapeutic options and the different strategies that can be applied according to the clinical status of patients. International experts address the different aspects of NSTE-ACS and bring useful information to clinicians, interventionalists and surgeons involved in the difficult management of these patients. The ESC Education SeriesThis book is part of the ESC Education Series. The series is designed to provide medical professionals with the latest information about the understanding, diagnosis and management of cardiovascular diseases. Where available, management recommendations are based on the established European Guidelines, which encompass the best techniques to use with each cardiac disease. Throughout the series, the leading international opinion leaders have been chosen to edit and contribute to the books. The information is presented in a succinct and accessible format with a clinical focus.
Michael Bertrand, Emeritus Professor of Cardiology, Lille Heart Institute, Lille, FranceDr Spencer King III, Fuqua Chair of Interventional Cardiolo, Fuqua institute, Atlanta, GA, USA
List of contributors viiiPreface xSection one: EpidemiologyChapter 1 Epidemiology of non-ST-segment elevation acute coronary syndromes 3David Hasdai and Alexander BattlerSection two: PathophysiologyChapter 2 Pathologic findings in acute coronary syndromes 11Erling FalkChapter 3 Vascular biology of acute coronary syndromes 24Lina BadimonSection three: Clinical aspects of ACSChapter 4 Clinical aspects of acute coronary syndromes 43Eugene McFaddenChapter 5 Circulating biomarkers for risk stratification 52Christopher HeeschenSection four: Investigation in ACSChapter 6 Coronary angiography angioscopy and intravascular ultrasound in non-ST-segment elevation acute coronary syndromes 65Eric Van Belle Christophe Bauters François Schiele and Michel E. BertrandChapter 7 New coronary imaging in acute coronary syndrome 78Pim J. de Feyter Evelyne Regar and Nico R.A. MolletSection five: Special groups of patientsChapter 8 Acute coronary syndromes in specialgroups of patients 97Piero O. Bonetti Michael J. Zellweger Christoph Kaiser and Matthias E. PfistererSection six: Pharmacological treatmentChapter 9 Antiischemic treatment (nitrates β-blockers calcium antagonists) 109David McCarty Colum G. Owens and A.A. Jennifer AdgeyChapter 10 Antiplatelet therapies: aspirin thienopyridines and glycoprotein IIb/IIIa receptor inhibitors 116Jaydeep Sarma and Keith A.A. FoxChapter 11 Antithrombin drugs: LMWH unfractionated heparin direct thrombin inhibitors 139Raphaelle Dumaine and Gilles MontalescotChapter 12 Statin therapy in ACS 152François SchieleSection seven: Myocardial revascularizationChapter 13 Percutaneous coronary interventions and stenting/CABG in non-ST-segment elevation acute coronary syndromes 165Nicolas Meneveau and Jean-Pierre BassandSection eight: Therapeutic strategyChapter 14 Risk stratification and therapeutic strategy 187Christian W. HammChapter 15 Indication for revascularization in non-ST-elevation acute coronary syndrome 199Lars WallentinChapter 16 Management of patients with nonamenable lesions for myocardialrevascul arization 211Victor LegrandChapter 17 Non-ST-segment elevation coronary syndromes: European Society of Cardiology guidelines 225Michel E. BertrandChapter 18 Non-ST-segment elevation acute coronary syndromes: ACC/AHA guidelines 236Pierre ThérouxChapter 19 From guidelines to registries 248Luigi TavazziSection nine: Secondary preventionChapter 20 Secondary prevention after acute episode of patients presenting with nonpersistent ST-segment elevation 261Michel E. BertrandChapter 21 How to detect vulnerable plaque 270Dirk Boese and Raimund ErbelChapter 22 Localversus systemic prevention treatment 281Mario Togni and Bernhard MeierConclusions 294Index 295