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Book Details
Abstract
Coronary artery disease continues to be a major cause of morbidity and mortality in the United States and throughout the world. This issue of the Heart Failure Clinics provides a contemporary and concise, yet extensive, review on all aspects of the management of patients with coronary artery disease. Topics include but are not limited to: Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease; Acute Coronary Syndromes: Unstable Angina and Non–ST Elevation Myocardial Infarction; Calcium Scoring and Cardiac Computed Tomography; Coronary Artery Disease and Diabetes Mellitus; Cardiac Syndrome X; and Revascularization Options: Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Coronary Artery Disease\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITORS | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease\r | v | ||
| Stable Ischemic Heart Disease\r | v | ||
| Acute Coronary Syndromes: Unstable Angina and Non–ST Elevation Myocardial Infarction\r | v | ||
| Current State of ST-Segment Myocardial Infarction: Evidence-based Therapies and\rOptimal Patient Outcomes in Advanced Systems of Care\r | v | ||
| Noninvasive Stress Testing for Coronary Artery Disease\r | vi | ||
| Invasive Testing for Coronary Artery Disease: FFR, IVUS, OCT, NIRS\r | vi | ||
| Calcium Scoring and Cardiac Computed Tomography\r | vi | ||
| Alternative Therapy for Medically Refractory Angina: Enhanced External\rCounterpulsation and Transmyocardial Laser Revascularization\r | vi | ||
| Coronary Artery Disease and Diabetes Mellitus\r | vii | ||
| Revascularization Options: Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention\r | vii | ||
| Cardiac Syndrome X: Update\r | vii | ||
| HEART FAILURE CLINICS\r | viii | ||
| FORTHCOMING ISSUES | viii | ||
| April 2016 | viii | ||
| July 2016 | viii | ||
| RECENT ISSUES | viii | ||
| October 2015 | viii | ||
| July 2015 | viii | ||
| Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease | 1 | ||
| Key points | 1 | ||
| EPIDEMIOLOGY OF CORONARY ARTERY DISEASE | 1 | ||
| Introduction | 1 | ||
| Prevalence | 1 | ||
| Incidence | 2 | ||
| Clinical Presentation of CAD | 2 | ||
| Myocardial infarction | 2 | ||
| Silent myocardial ischemia and infarction | 3 | ||
| Sudden cardiac death | 3 | ||
| Risk Factors | 3 | ||
| CAD risk equivalents | 3 | ||
| Risk factors of CAD | 4 | ||
| NOVEL AND EMERGING RISK FACTORS | 5 | ||
| GENETIC TESTING | 5 | ||
| SUMMARY | 5 | ||
| REFERENCES | 6 | ||
| Stable Ischemic Heart Disease | 11 | ||
| Key points | 11 | ||
| DEFINITION AND CLINICAL DIAGNOSIS | 11 | ||
| Silent Ischemia and Infarction Is Frequent | 12 | ||
| GOALS OF THERAPY, FUNCTIONAL CLASSIFICATION, AND SEVERITY | 13 | ||
| Myocardial Energy (Oxygen) Imbalance and Ischemic Pain | 13 | ||
| Pretest Probability of Ischemia Graded According to Gender, Age, and Symptoms | 13 | ||
| Classifications that Include Additional Clinical and Baseline ECG Findings | 13 | ||
| ANTI-ISCHEMIC THERAPY | 14 | ||
| Organic Nitrates | 14 | ||
| β-Blockers | 16 | ||
| Calcium Channel Blockers | 16 | ||
| NEWER, NONTRADITIONAL, UNIQUE, ANTI-ISCHEMIC AGENTS | 19 | ||
| Nicorandil | 19 | ||
| Ivabradine | 19 | ||
| Trimetazidine | 19 | ||
| Fasudil | 22 | ||
| Ranolazine | 22 | ||
| SECONDARY PREVENTION | 23 | ||
| MANAGEMENT OF RISK FACTORS | 24 | ||
| REFERENCES | 27 | ||
| Acute Coronary Syndromes | 31 | ||
| Key points | 31 | ||
| PATHOPHYSIOLOGY | 32 | ||
| DIAGNOSIS AND RISK STRATIFICATION | 32 | ||
| ANTIPLATELET THERAPY | 32 | ||
| Aspirin | 32 | ||
| Clopidogrel | 32 | ||
| Prasugrel | 34 | ||
| Ticagrelor | 35 | ||
| Glycoprotein IIb/IIIa Inhibitors | 38 | ||
| Cangrelor | 38 | ||
| ANTICOAGULANT THERAPY | 38 | ||
| Unfractionated Heparin | 38 | ||
| Enoxaparin | 38 | ||
| Fondaparinux | 38 | ||
| Bivalirudin | 39 | ||
| Novel Oral Anticoagulants | 39 | ||
| ANTI-ISCHEMIC THERAPY | 39 | ||
| β-Blockers | 39 | ||
| Inhibitors of the Renin-Angiotensin-Aldosterone System | 39 | ||
| Calcium Channel Blockers | 39 | ||
| Nitrates | 39 | ||
| Ranolazine | 42 | ||
| LIPID-LOWERING THERAPY | 42 | ||
| EARLY INVASIVE STRATEGY VERSUS INITIAL CONSERVATIVE APPROACH | 42 | ||
| TIMING OF INVASIVE THERAPY | 42 | ||
| ADDITIONAL CONSIDERATIONS AND PATIENT SUBGROUPS | 43 | ||
| Diabetes Mellitus | 43 | ||
| Chronic Kidney Disease | 43 | ||
| SUMMARY | 44 | ||
| REFERENCES | 44 | ||
| Current State of ST-Segment Myocardial Infarction | 49 | ||
| Key points | 49 | ||
| INTRODUCTION | 49 | ||
| Early Evidence in STEMI Reperfusion | 50 | ||
| Coronary Stents and Contemporary Primary PCI | 51 | ||
| Surrogate Markers of Reperfusion in STEMI | 53 | ||
| Thrombectomy and Embolic Protection Devices | 53 | ||
| Novel Adjunctive Therapies | 54 | ||
| Antiplatelet and Antithrombotic Therapies in STEMI | 54 | ||
| New Challenges in STEMI | 56 | ||
| Cardiogenic Shock and Ventricular Assistive Devices in STEMI | 56 | ||
| Timely Reperfusion and Patient Outcomes | 57 | ||
| Treating STEMI in Regional Systems of Care | 58 | ||
| SUMMARY | 60 | ||
| REFERENCES | 60 | ||
| Noninvasive Stress Testing for Coronary Artery Disease | 65 | ||
| Key points | 65 | ||
| INTRODUCTION | 65 | ||
| Stress Testing for Diagnostic Purposes | 66 | ||
| Impact of Verification Bias on Diagnostic Accuracy | 66 | ||
| Stress Testing for Risk Stratification | 66 | ||
| Risk Stratification by Standard ETT | 67 | ||
| Risk Stratification by Treadmill Scores | 67 | ||
| Risk Stratification with SPECT | 67 | ||
| Other SPECT Prognostic Variables | 70 | ||
| Stress PET for Risk Stratification | 70 | ||
| Stress Echocardiography for Risk Stratification | 71 | ||
| Comparison Between Standard ETT and Stress Imaging | 73 | ||
| Standard ETT Versus Stress Imaging in the Presence of a Normal Resting ECG | 73 | ||
| Choosing Between Standard ETT Versus Stress Imaging | 73 | ||
| Choosing Between SPECT and Echocardiography | 73 | ||
| Correct Interpretation of a Stress Imaging Study | 75 | ||
| Recent Randomized Trials of Stress Testing | 75 | ||
| Stress Imaging Substudies in Recent Randomized Trials | 76 | ||
| Future Directions | 78 | ||
| REFERENCES | 78 | ||
| Invasive Testing for Coronary Artery Disease | 83 | ||
| Key points | 83 | ||
| INTRODUCTION | 83 | ||
| FFR | 84 | ||
| IVUS | 87 | ||
| OCT | 89 | ||
| NIRS | 90 | ||
| SUMMARY | 92 | ||
| REFERENCES | 92 | ||
| Calcium Scoring and Cardiac Computed Tomography | 97 | ||
| Key points | 97 | ||
| INTRODUCTION | 97 | ||
| BACKGROUND | 97 | ||
| CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY | 98 | ||
| Diagnostic Accuracy of CT Angiography | 98 | ||
| Beyond Coronary Imaging: The Triple Rule-Out Scan | 99 | ||
| Clinical application of CCTA in the ED for evaluation of chest pain: selection of patients | 100 | ||
| Evaluating for Vulnerable Plaque | 100 | ||
| Evaluating Incidentally Found Coronary Artery Calcification on CT Scans | 100 | ||
| SUMMARY | 102 | ||
| REFERENCES | 102 | ||
| Alternative Therapy for Medically Refractory Angina | 107 | ||
| Key points | 107 | ||
| INTRODUCTION | 107 | ||
| EECP THERAPY | 108 | ||
| EECP THERAPY IN RAP MANAGEMENT | 108 | ||
| TRANSMYOCARDIAL LASER REVASCULARIZATION | 112 | ||
| PERCUTANEOUS TRANSMYOCARDIAL LASER REVASCULARIZATION | 113 | ||
| ACC/AHA AND ESC GUIDELINES | 113 | ||
| REFERENCES | 114 | ||
| Coronary Artery Disease and Diabetes Mellitus | 117 | ||
| Key points | 117 | ||
| INTRODUCTION | 117 | ||
| GLYCEMIC CONTROL AND CARDIOVASCULAR OUTCOMES | 118 | ||
| Antidiabetic Drug Safety | 119 | ||
| Hypoglycemia and Mortality | 121 | ||
| MANAGEMENT OF HYPERLIPIDEMIA IN PATIENTS WITH DM | 121 | ||
| STATIN USE AND RISK OF DIABETES | 122 | ||
| CORONARY REVASCULARIZATION IN PATIENTS WITH DM | 124 | ||
| Revascularization Versus Medical Therapy | 124 | ||
| Use of Drug-Eluting Stents in Patients with DM | 124 | ||
| Stent Thrombosis After DES Implantation | 124 | ||
| CABG Versus PCI in Multivessel CAD | 126 | ||
| Explaining the Mortality Benefit of CABG | 127 | ||
| Graft Selection and Patency in Patients with DM | 127 | ||
| APPROACH TO CORONARY REVASCULARIZATION IN PATIENTS WITH DM | 127 | ||
| REFERENCES | 129 | ||
| Revascularization Options | 135 | ||
| Key points | 135 | ||
| INTRODUCTION | 135 | ||
| CLINICAL TRIALS COMPARING CABG VERSUS PCI | 136 | ||
| MULTIVESSEL DISEASE | 136 | ||
| LEFT MAIN DISEASE | 137 | ||
| SUMMARY | 138 | ||
| REFERENCES | 138 | ||
| Cardiac Syndrome X | 141 | ||
| Key points | 141 | ||
| INTRODUCTION | 141 | ||
| EPIDEMIOLOGY | 142 | ||
| PROGNOSIS | 142 | ||
| DIAGNOSIS | 143 | ||
| Clinical Features | 143 | ||
| History | 143 | ||
| ECG | 143 | ||
| Coronary angiography | 143 | ||
| Differential Diagnosis | 143 | ||
| PATHOGENESIS OVERVIEW | 144 | ||
| CMD | 144 | ||
| Normal Coronary Microvascular Function | 144 | ||
| Assessment of Coronary Microvascular Function | 145 | ||
| Impaired Coronary Microvascular Function | 145 | ||
| Risk Factors | 145 | ||
| ENHANCED PAIN SENSITIVITY | 145 | ||
| Origin of the Enhanced Pain Sensitivity Theory | 145 | ||
| Psychological and Behavioral Factors | 147 | ||
| PATHOGENESIS SUMMARY | 148 | ||
| TREATMENT OVERVIEW | 148 | ||
| ANTI-ISCHEMIC PHARMACOLOGIC TREATMENTS | 148 | ||
| Nitrates | 148 | ||
| β-Adrenergic Receptor Blockers | 148 | ||
| Calcium Channel Antagonists | 149 | ||
| Ranolazine | 149 | ||
| Angiotensin-Converting Enzyme Inhibitors | 149 | ||
| Statins | 149 | ||
| ANALGESIC PHARMACOLOGIC TREATMENTS | 150 | ||
| Xanthine Derivatives | 150 | ||
| Tricyclic Antidepressants | 150 | ||
| NONPHARMACOLOGIC TREATMENT | 150 | ||
| Cognitive-Behavioral Therapy | 150 | ||
| Enhanced External Counterpulsation | 150 | ||
| Neurostimulation | 150 | ||
| Stellate Ganglionectomy | 151 | ||
| LIFESTYLE MODIFICATIONS | 151 | ||
| TREATMENT CONCLUSION | 151 | ||
| SUMMARY | 152 | ||
| REFERENCES | 152 |