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Doody's Review ServiceReviewer: John F. Moran, MD (Loyola University Stritch School of Medicine)
Description: The spectrum of acute coronary syndromes are covered in this book in ten chapters, from pathophysiology to the potential of gene therapy.
Purpose: The purpose is to allow readers to understand the pathophysiologic mechanisms of coronary syndromes and apply that knowledge to patient care. This is indeed a worthy subject because acute coronary syndromes or unstable angina/non-Q wave myocardial infarction is a very common problem.
Audience: This book would be enjoyed by internists as well as cardiologists but may be best suited for clinician scientists and cardiology trainees because of the focus on cellular molecular mechanisms as well as future genetic potential mechanisms.
Features: The editor focuses on the pathophysiology of unstable angina and reviews some data that created controversies in this area. The ten chapters are divided into three sections: pathophysiology, acute coronary syndrome, and potential future treatments. There is an excellent review of the pathogenesis of atherosclerosis which is extremely well referenced. There is an emphasis on cellular molecular mechanisms with good discussions of the vulnerable plaque with sections on plaque inflammation triggering and the interaction of TPMPAI-I. The medical management of acute myocardial infarction is well covered and well referenced, as is coronary angioplasty in acute myocardial infarction. In the final chapters contributors deal with gene therapy and angiogenesis, including discussion of grafts of healthy myocytes to diseased hearts. Tables, graphs, and illustrations complement the text.
Assessment: This is a good addition to the medical literature. This same area is covered in two other texts with slightly different foci: Topol's Acute Coronary Syndromes (Marcel Dekker, 1998), and Cannon's Management of Acute Coronary Syndromes (Humana Press, 1999). Much of the same material is covered in these texts as the one reviewed here, but the focus of this text is more on pathophysiology and cellular molecular mechanisms. The focus in the other texts is more on treatment and diagnosis with electrocardiography, female implications, young patients, coronary presentations, cost effectiveness, and quality/outcomes of treatments . Acute coronary syndromes represent a very important area and a large patient population for medical practice.