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Book Details
Abstract
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.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| MYOCARDIAL INFARCTION | i | ||
| MYOCARDIAL INFARCTION: A Companion to Braunwald’s Heart Disease | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Foreword | xiii | ||
| Preface | xv | ||
| Contents | xvii | ||
| Video Contents | xix | ||
| Braunwald’s Heart Disease Family of Books | xxi | ||
| BRAUNWALD’S HEART DISEASE COMPANIONS | xxi | ||
| BRAUNWALD’S HEART DISEASE REVIEW AND ASSESSMENT | xxiii | ||
| BRAUNWALD’S HEART DISEASE IMAGING COMPANIONS | xxiii | ||
| COMING SOON! | xxiii | ||
| I - Epidemiology and Pathophysiology | 1 | ||
| 1 - CLASSIFICATION AND DIAGNOSIS OF ACUTE CORONARY SYNDROMES\r | 1 | ||
| INTRODUCTION | 1 | ||
| SPECTRUM OF UNSTABLE ISCHEMIC HEART DISEASE | 1 | ||
| Unstable Angina: A Historical Perspective | 2 | ||
| Diagnosis of Myocardial Infarction | 3 | ||
| Biomarkers of Myocyte Necrosis | 3 | ||
| CLASSICATION OF MYOCARDIAL INFARCTION | 5 | ||
| Pathological Description | 5 | ||
| Clinical Classification | 5 | ||
| Electrocardiography | 5 | ||
| Universal Definition of Myocardial Infarction Classification of Myocardial Infarction Type | 6 | ||
| Spontaneous Myocardial Infarction (Type 1) | 6 | ||
| Myocardial Infarction Secondary to an Ischemic Imbalance (Type 2) | 6 | ||
| Cardiac Death Caused by Myocardial Infarction (Type 3) | 7 | ||
| Myocardial Infarction Associated with Revascularization Procedures (Types 4 and 5) | 8 | ||
| Classification by Myocardial Infarction Size | 8 | ||
| Myocardial Infarction in the Setting of Nonobstructive Coronary Arteries | 9 | ||
| SUMMARY | 9 | ||
| Classic References | 10 | ||
| References | 10 | ||
| 2 - GLOBAL EVOLVING EPIDEMIOLOGY, NATURAL HISTORY, AND TREATMENT TRENDS OF MYOCARDIAL INFARCTION | 11 | ||
| INTRODUCTION | 11 | ||
| Data Sources | 11 | ||
| MORTALITY AND MORBIDITY DUE TO MYOCARDIAL INFARCTION | 11 | ||
| VARIATION IN THE GLOBAL BURDEN OF ISCHEMIC HEART DISEASE | 14 | ||
| High-Income Countries | 14 | ||
| Low- and Middle-Income Countries | 14 | ||
| East Asia and the Pacific | 14 | ||
| Central and Eastern Europe and Central Asia | 14 | ||
| Latin America and the Caribbean | 14 | ||
| North Africa and the Middle East | 14 | ||
| South Asia | 14 | ||
| Sub-Saharan Africa | 15 | ||
| ECONOMIC BURDEN OF ISCHEMIC HEART DISEASE | 15 | ||
| INTERVENTIONS | 15 | ||
| Acute Management | 15 | ||
| Cost-Effectiveness of Acute Management Strategies | 16 | ||
| Secondary Prevention of Myocardial Infarction | 17 | ||
| Access to Essential Medications for Secondary Prevention of Cardiovascular Disease | 18 | ||
| Medication Adherence | 19 | ||
| Smoking Cessation | 19 | ||
| Cost-Effective Interventions | 19 | ||
| SUMMARY AND FUTURE DIRECTIONS | 20 | ||
| References | 20 | ||
| 3 - NEW AND EMERGING INSIGHTS INTO THE PATHOBIOLOGY OF ACUTE MYOCARDIAL INFARCTION | 22 | ||
| MULTIFACTORIAL CAUSES | 22 | ||
| MECHANISMS OF PLAQUE FORMATION | 22 | ||
| Lesion Classification | 23 | ||
| Lipoprotein Retention | 23 | ||
| Inflammation | 24 | ||
| Foam Cells | 25 | ||
| Fatty Streaks | 25 | ||
| Necrosis | 25 | ||
| Plaque Angiogenesis and Intraplaque Hemorrhage | 26 | ||
| Fibrosis | 26 | ||
| Calcification | 26 | ||
| Arterial Remodeling | 27 | ||
| CLINICAL MANIFESTATIONS OF ATHEROSCLEROSIS | 27 | ||
| Mechanisms of Plaque Rupture | 29 | ||
| Thin-Cap Fibroatheroma | 29 | ||
| Mechanisms of Plaque Erosion | 29 | ||
| Plaque Thrombogenicity and Thrombosis | 30 | ||
| Healed Plaques and Incorporated Thrombi | 30 | ||
| Plaque Regression | 30 | ||
| PLAQUE BURDEN | 30 | ||
| PLAQUE ACTIVITY | 30 | ||
| PLAQUE VULNERABILITY | 31 | ||
| RUPTURE-PRONE PLAQUES | 31 | ||
| Necrotic Core | 31 | ||
| Plaque Size and Severity of Stenosis | 31 | ||
| Other Associated Features | 32 | ||
| Predictive Value of Vulnerable Plaque Features | 32 | ||
| PERSPECTIVES FOR PREVENTION | 32 | ||
| References | 32 | ||
| 4 - MECHANISMS OF MYOCARDIAL ISCHEMIC INJURY, HEALING, AND REMODELING\r | 34 | ||
| Historical Perspective | 34 | ||
| The Concept of Mutability of Myocardial Infarction: Oxygen Supply and Demand Balance, Reperfusion, and Remodeling | 34 | ||
| PATHOLOGICAL FINDINGS DURING THE EVOLUTION AND HEALING OF MYOCARDIAL INFARCTION | 35 | ||
| THE CURRENT ERA: THE ROLE OF INFLAMMATION IN THE EVOLUTION AND HEALING OF MYOCARDIAL INFARCTION | 36 | ||
| Inflammatory Response to Myocardial Infarction | 37 | ||
| Inflammatory Cells and Infarct Healing | 37 | ||
| Role of Specific Leukocyte Classes | 37 | ||
| Monocyte Origins in Myocardial Infarction | 38 | ||
| “Cardiosplenic” Axis in Humans | 39 | ||
| Areas of Ongoing Investigation | 40 | ||
| SUMMARY | 41 | ||
| ACKNOWLEDGEMENTS | 41 | ||
| Classic References | 41 | ||
| References | 41 | ||
| II - Initial Evaluation andRisk Stratification | 43 | ||
| 5 - PREHOSPITAL ASSESSMENT AND SYSTEMS OF CARE | 43 | ||
| CASE VIGNETTE | 43 | ||
| INTRODUCTION | 43 | ||
| PREHOSPITAL EVALUATION | 44 | ||
| Evolution of Emergency Medical Services | 44 | ||
| Prehospital Systems | 45 | ||
| Integrated Emergency Medical Systems | 45 | ||
| SYSTEMS OF CARE IN PRACTICE | 46 | ||
| ST-Elevation Myocardial Infarction Systems of Care: The European Experience | 46 | ||
| ST-Elevation Myocardial Infarction Systems of Care: The United States | 47 | ||
| Professional Society Guidelines | 48 | ||
| UNITED STATES CARDIOVASCULAR SYSTEMS OF CARE: THE CURRENT LANDSCAPE | 49 | ||
| The Ideal System of Care Network | 49 | ||
| Systems of Care: Successes and Advantages | 51 | ||
| Systems of Care: Current Challenges, Gaps, and Barriers | 51 | ||
| Systems Delays | 51 | ||
| Resources for Staffing, Research, and Quality Improvement | 51 | ||
| Public Policy and Consideration of Need | 51 | ||
| Other Issues: In-Hospital ST-Elevation Myocardial Infarction and False Activations | 52 | ||
| FUTURE DIRECTIONS AND STRATEGIES FOR IMPROVEMENT | 52 | ||
| References | 54 | ||
| 6 - Clinical Practice/Controversy:CLINICAL APPROACH TO SUSPECTED ACUTE MYOCARDIAL INFARCTION | 55 | ||
| INTRODUCTION | 55 | ||
| GOALS OF THE INITIAL ASSESSMENT OF SUSPECTED MYOCARDIAL INFARCTION | 55 | ||
| CAUSES OF CHEST DISCOMFORT | 55 | ||
| Myocardial Ischemia | 55 | ||
| Characteristics of Myocardial Ischemia | 57 | ||
| Nonischemic Causes of Chest Discomfort | 59 | ||
| Cardiopulmonary Causes | 59 | ||
| Pericardial and Myocardial Diseases | 59 | ||
| Acute Aortic Syndromes | 59 | ||
| Pulmonary Embolism | 59 | ||
| Other Pulmonary Causes | 59 | ||
| Musculoskeletal | 59 | ||
| Panic Disorder | 59 | ||
| CLINICAL APPROACH TO THE PATIENT | 59 | ||
| History | 59 | ||
| Quality of the Pain | 59 | ||
| Location of the Discomfort | 60 | ||
| Pattern | 60 | ||
| Provoking and Alleviating Factors | 60 | ||
| Associated Symptoms | 60 | ||
| Medical History and Review of Systems | 61 | ||
| Physical Examination | 61 | ||
| General | 61 | ||
| Cardiopulmonary | 61 | ||
| Vascular | 62 | ||
| Other Elements of the Examination | 62 | ||
| Electrocardiography | 62 | ||
| Cardiac Biomarkers | 62 | ||
| Chest Radiography | 63 | ||
| Formulating a Clinical Probability of Myocardial Infarction | 63 | ||
| DECISIONS REGARDING ADDITIONAL TESTING | 64 | ||
| Invasive Coronary Evaluation | 64 | ||
| Provocative Testing for Ischemia | 64 | ||
| Other Noninvasive Studies | 64 | ||
| CRITICAL PATHWAYS | 64 | ||
| SUMMARY | 64 | ||
| References | 65 | ||
| 7 - Optimal Use of Cardiac Troponin in Patients with Chest Discomfort | 66 | ||
| INTRODUCTION | 66 | ||
| BASIC CONSIDERATIONS ABOUT CARDIAC TROPONIN FOR CLINICIANS | 66 | ||
| Specificity and Interferences | 66 | ||
| Interfering Proteins | 66 | ||
| Impact of Blood Sampling | 66 | ||
| Sensitivity | 67 | ||
| The 99th Percentile Reference Limit | 67 | ||
| Advanced Considerations | 67 | ||
| Sex-Specific Cutoffs | 68 | ||
| Definition of a Changing Pattern of Cardiac Troponin Values | 69 | ||
| Challenges in Defining a Change Criterion | 69 | ||
| Sampling and Reporting | 70 | ||
| THE IMPORTANCE OF CLINICAL CONTEXT | 70 | ||
| A Bayesian Approach to the Chest Pain Patient | 70 | ||
| Rapid Rule-Out Protocols Using Troponin in Low-Risk Patients | 71 | ||
| Standard Troponin Assays | 71 | ||
| High-Sensitivity Assays for Troponin | 71 | ||
| Caveats for Clinical Application of Rapid Rule-Out Strategies | 72 | ||
| High-Risk Patients | 72 | ||
| Contemporary Assays | 72 | ||
| High-Sensitivity Assays | 72 | ||
| Patients with Intermediate Risk | 73 | ||
| Special Subsets with Possible Myocardial Infarction | 73 | ||
| Women | 73 | ||
| Renal Failure | 73 | ||
| Older Patients | 73 | ||
| TYPE 1 VERSUS TYPE 2 ACUTE MYOCARDIAL INFARCTION AND CARDIAC INJURY | 73 | ||
| SITUATIONS THAT MAY BE CONFUSED WITH MYOCARDIAL INFARCTION | 74 | ||
| Pulmonary Embolism | 74 | ||
| Aortic Dissection | 74 | ||
| Carbon Monoxide Poisoning | 74 | ||
| Acute Heart Failure | 74 | ||
| Critical Illness | 74 | ||
| Management | 75 | ||
| SUMMARY | 75 | ||
| References | 75 | ||
| 8 - OTHER BIOMARKERS AND THE EVALUATION OF PATIENTS WITH SUSPECTED MYOCARDIAL ISCHEMIA | 77 | ||
| INTRODUCTION | 77 | ||
| RATIONAL SEARCH FOR CARDIOVASCULAR BIOMARKERS | 77 | ||
| DIAGNOSTIC APPLICATIONS | 77 | ||
| Biomarkers Indicative of Ischemia | 77 | ||
| Copeptin | 77 | ||
| Other Putative Biomarkers of Ischemia | 79 | ||
| Biomarkers of Necrosis | 79 | ||
| General Considerations | 79 | ||
| Heart-Type Fatty Acid-Binding Protein | 79 | ||
| Biomarkers of Plaque Instability | 80 | ||
| Myeloperoxidase | 80 | ||
| Angiogenic Factors | 81 | ||
| PROGNOSTIC APPLICATIONS | 81 | ||
| Biomarkers of Hemodynamic Stress | 81 | ||
| Natriuretic Peptides | 81 | ||
| Novel Biomarkers of Hemodynamic Stress | 82 | ||
| ST2 | 82 | ||
| Mid-Region Pro-Adrenomedullin | 84 | ||
| Inflammatory Biomarkers and Prognosis | 84 | ||
| Growth-Differentiation Factor-15 | 85 | ||
| Prognostic Markers and Clinical Decision-Making | 85 | ||
| FORWARD OUTLOOK | 86 | ||
| MicroRNA | 86 | ||
| SUMMARY | 87 | ||
| References | 87 | ||
| 9 - CARDIAC IMAGING FOR PATIENTS WITH ACUTE CHEST PAIN IN THE EMERGENCY DEPARTMENT | 89 | ||
| INTRODUCTION | 89 | ||
| Rationale for Functional and Anatomic Assessment | 89 | ||
| Anatomic Assessment of Coronary Artery Disease | 89 | ||
| Functional Imaging | 89 | ||
| Rest Radionuclide Myocardial Perfusion Imaging | 90 | ||
| Rest-Only Myocardial Perfusion Imaging in Suspected Acute Coronary Syndromes | 90 | ||
| Randomized Trials of Myocardial Perfusion Imaging in the Emergency Department | 90 | ||
| Appropriate Use Criteria, Guidelines, and Clinical Role | 91 | ||
| Resting Echocardiography | 91 | ||
| Echocardiography in Acute Coronary Syndrome | 91 | ||
| Echocardiographic Imaging with Contrast | 91 | ||
| III - Treatment | 139 | ||
| 13 - MANAGEMENT PRINCIPLES IN MYOCARDIAL INFARCTION | 139 | ||
| INTRODUCTION | 139 | ||
| PREHOSPITAL MANAGEMENT | 140 | ||
| Early Recognition of Myocardial Infarction | 140 | ||
| Cardiac Arrest | 141 | ||
| Systems Development for Rapid Reperfusion | 141 | ||
| EMERGENCY IN-HOSPITAL MANAGEMENT | 141 | ||
| Rapid Reperfusion | 141 | ||
| Fibrinolysis | 142 | ||
| Pathways of Care: ST-Elevation Myocardial Infarction | 142 | ||
| Pathways of Care: Non–ST-Elevation Myocardial Infarction | 142 | ||
| Other Medical Therapy at Presentation | 143 | ||
| Analgesics | 143 | ||
| Nitrates | 144 | ||
| Oxygen | 144 | ||
| RECURRENT ISCHEMIA | 144 | ||
| Initial Risk Assessment | 145 | ||
| Thrombotic Complications | 146 | ||
| Antiplatelet Therapies | 146 | ||
| Aspirin | 147 | ||
| P2Y12 Receptor Inhibition | 147 | ||
| Glycoprotein IIb/IIIa Inhibitors | 147 | ||
| Anticoagulant Therapy | 147 | ||
| Unfractionated Heparin | 147 | ||
| Low–Molecular-Weight Heparins | 147 | ||
| Factor Xa Inhibitor | 147 | ||
| Direct Thrombin Inhibitors | 148 | ||
| Other Medical Therapies to Reduce Ischemia | 148 | ||
| Nitrates | 148 | ||
| Calcium Channel Blockers | 148 | ||
| Beta-Adrenergic Blockers | 148 | ||
| Coronary Revascularization | 148 | ||
| Identification of Occult Ischemia | 149 | ||
| Invasive Detection of Occult Ischemia | 149 | ||
| Noninvasive Detection of Occult Ischemia | 149 | ||
| ELECTRICAL AND MECHANICAL COMPLICATIONS | 149 | ||
| Arrhythmias | 149 | ||
| Mechanical Complications | 149 | ||
| ADJUNCTIVE THERAPIES IN THE ACUTE PHASE | 150 | ||
| Lipid-Lowering Agents | 150 | ||
| Management of Hyperglycemia | 150 | ||
| SECONDARY PREVENTION AND REHABILITATION | 150 | ||
| Duration of Therapy | 150 | ||
| Lifestyle Changes and Cardiac Rehabilitation | 151 | ||
| FUTURE PERSPECTIVES | 151 | ||
| References | 152 | ||
| 14 - Clinical Practice/Controversy: SELECTION OF REPERFUSION THERAPY AND TRANSFER STRATEGIES FOR PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION | 154 | ||
| CASE PRESENTATION | 154 | ||
| INTRODUCTION | 154 | ||
| ELEMENTS THAT INFLUENCE REPERFUSION DELAY FOR PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN TRANSFER PATIENTS | 155 | ||
| Patient Delay | 155 | ||
| Prehospital System Delay | 155 | ||
| Interhospital System Delay | 156 | ||
| Door-in-Door-out Time | 156 | ||
| Mode of Transfer | 156 | ||
| Primary Percutaneous Coronary Intervention Center Logistics Delay | 156 | ||
| CHOICE OF REPERFUSION STRATEGY IN TRANSFER PATIENTS | 157 | ||
| Influence of Index ST-Elevation Myocardial Infarction Risk | 157 | ||
| Influence of the Risk of Fibrinolysis | 158 | ||
| Influence of Ischemic Time | 159 | ||
| Early Presenters | 159 | ||
| Late Presenters | 160 | ||
| Influence of Transfer Time to Primary Percutaneous Coronary Intervention versus Fibrinolysis | 160 | ||
| Percutaneous Coronary Intervention–Related Delay | 161 | ||
| Summary of Considerations for Selection of Reperfusion Therapy | 161 | ||
| KEY ELEMENTS OF A SUCCESSFUL PHARMACOINVASIVE APPROACH | 162 | ||
| Prehospital Fibrinolysis | 162 | ||
| Rescue Intervention | 162 | ||
| Routine Mechanical Co-Intervention | 163 | ||
| Transfer After Fibrinolysis | 163 | ||
| ADJUNCTIVE THERAPIES TO REPERFUSION IN TRANSFER PATIENTS | 164 | ||
| ST-ELEVATION MYOCARDIAL INFARCTION NETWORKS | 164 | ||
| WHAT DO THE GUIDELINES RECOMMEND? | 164 | ||
| RECOMMENDED APPROACH TO ST-ELEVATION MYOCARDIAL INFARCTION CARE USING A DUAL REPERFUSION STRATEGY | 165 | ||
| RETURN TO THE CASE | 165 | ||
| FUTURE PERSPECTIVES | 165 | ||
| References | 167 | ||
| 15 - FIBRINOLYTIC THERAPY FOR PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION\r | 169 | ||
| INTRODUCTION | 169 | ||
| A BRIEF HISTORICAL OVERVIEW | 169 | ||
| Role of Fibrinolysis in Contemporary Care | 169 | ||
| HOW DO FIBRINOLYTIC AGENTS WORK? | 171 | ||
| SPECIFIC FIBRINOLYTIC AGENTS | 171 | ||
| Streptokinase | 171 | ||
| Clinical Trials of Streptokinase | 172 | ||
| Tissue-Type Plasminogen Activator | 172 | ||
| Clinical Trials of Tissue-Plasminogen Activator | 173 | ||
| Reteplase | 173 | ||
| Clinical Trials of Reteplase | 173 | ||
| Tenecteplase | 174 | ||
| Clinical Trials of Tenecteplase | 174 | ||
| Lanoteplase | 174 | ||
| Fibrinolytics of Historical Interest | 175 | ||
| Staphylokinase | 175 | ||
| Saruplase | 175 | ||
| Amediplase | 175 | ||
| CLINICAL USE, INDICATIONS, AND CONTRAINDICATIONS FOR FIBRINOLYTIC THERAPY | 176 | ||
| Indications for Fibrinolytic Therapy | 176 | ||
| Contraindications to Fibrinolysis | 176 | ||
| ASSESSMENT OF REPERFUSION | 176 | ||
| Concomitant Therapies | 176 | ||
| Anticoagulation with Fibrinolysis | 177 | ||
| Unfractionated Heparin | 177 | ||
| Low–Molecular-Weight Heparins and Pentasaccharides | 177 | ||
| Direct Thrombin Inhibitors | 177 | ||
| Antiplatelet Agents with Fibrinolysis | 177 | ||
| Adenosine Diphosphate Receptor Antagonists | 178 | ||
| Glycoprotein IIb/IIIa Antagonists | 178 | ||
| PREHOSPITAL FIBRINOLYSIS | 178 | ||
| SUMMARY | 179 | ||
| Classic References | 179 | ||
| References | 179 | ||
| 16 - REVASCULARIZATION IN NON–ST-ELEVATION ACUTE CORONARY SYNDROME: FOR WHOM, WHEN, AND HOW?\r | 180 | ||
| INTRODUCTION | 180 | ||
| CORONARY ANGIOGRAPHY | 180 | ||
| Identification of the Culprit Lesion | 180 | ||
| ROUTINE INVASIVE VERSUS SELECTIVE INVASIVE MANAGEMENT | 181 | ||
| Meta-Analyses | 182 | ||
| Long-Term Outcomes | 183 | ||
| Patient Selection | 183 | ||
| TIMING OF REVASCULARIZATION | 184 | ||
| Candidates for Immediate Invasive Evaluation | 184 | ||
| Randomized Trials | 185 | ||
| Professional Guidelines | 185 | ||
| REVASCULARIZATION IN SUBSETS OF PATIENTS WITH NON–ST-ELEVATION ACUTE CORONARY SYNDROME | 186 | ||
| Chronic Kidney Disease | 186 | ||
| Elderly Patients | 187 | ||
| Gender and Selection of Invasive Treatment | 187 | ||
| REVASCULARIZATION STRATEGY: PERCUTANEOUS CORONARY INTERVENTION VERSUS CORONARY ARTERY BYPASS GRAFTING | 187 | ||
| SUMMARY | 188 | ||
| Classic References | 188 | ||
| References | 189 | ||
| 17 - APPROACH TO PERCUTANEOUS CORONARY INTERVENTION IN MYOCARDIAL INFARCTION\r | 190 | ||
| TIMING OF PERCUTANEOUS CORONARY INTERVENTION | 190 | ||
| ST-Elevation Myocardial Infarction Strategies for Reducing Time to Treatment | 190 | ||
| Non–ST-Elevation Myocardial Infarction: Timing of Angiography | 190 | ||
| VASCULAR ACCESS | 191 | ||
| Performing Vascular Access | 191 | ||
| Femoral | 191 | ||
| Radial | 192 | ||
| Advantages and Disadvantages of Radial versus Femoral Access | 192 | ||
| Current Evidence: Radial versus Femoral | 192 | ||
| Considerations for Radial Approach in ST-Elevation Myocardial Infarction | 193 | ||
| Vascular Closure Devices: When to Consider Use | 193 | ||
| Management of Vascular Complications | 193 | ||
| INTERVENTIONAL PHARMACOTHERAPY | 193 | ||
| Procedural Sedation | 193 | ||
| Oral Antiplatelet Therapy | 194 | ||
| When to Preload with Oral Adenosine Diphosphate P2Y12 Inhibitors | 194 | ||
| Anticoagulation Strategies | 194 | ||
| Practical Aspects of Monitoring Anticoagulation | 194 | ||
| Current Evidence: Bivalirudin versus Heparin in ST-Elevation Myocardial Infarction | 194 | ||
| Intravenous Antiplatelet Therapy | 195 | ||
| When to Use a Glycoprotein IIb/IIIa Inhibitor? | 195 | ||
| Role for Intravenous Adenosine Diphosphate P2Y12 Inhibitors? | 195 | ||
| Practical Considerations for Patients on Oral Anticoagulation | 195 | ||
| PERCUTANEOUS CORONARY INTERVENTION | 195 | ||
| Rationale for Stenting | 195 | ||
| When Is Balloon Angioplasty Alone Sufficient? | 195 | ||
| ST-Elevation Myocardial Infarction: Direct Stenting versus Predilation | 195 | ||
| Drug-Eluting Stents versus Bare Metal Stents | 196 | ||
| Rationale for Drug-Eluting Stent Development | 196 | ||
| Evidence in Acute Myocardial Infarction | 197 | ||
| Practical Considerations | 197 | ||
| Current Drug-Eluting Stent Platforms | 197 | ||
| Emerging Stent or Balloon Platforms | 197 | ||
| ADJUNCTIVE DIAGNOSTIC AND THERAPEUTIC DEVICES | 198 | ||
| Practical Use of Intravascular Imaging | 198 | ||
| When to Use Fractional Flow Reserve in Acute Myocardial Infarction? | 198 | ||
| Aspiration Thrombectomy | 198 | ||
| Distal Embolic Protection | 198 | ||
| LESION-SPECIFIC PERCUTANEOUS CORONARY INTERVENTION STRATEGIES | 199 | ||
| Bifurcation Lesions | 199 | ||
| Left Main Coronary Artery | 200 | ||
| Aorto-Ostial Lesions | 201 | ||
| Saphenous Vein Graft | 201 | ||
| Calcified Lesions | 201 | ||
| NONCULPRIT REVASCULARIZATION | 201 | ||
| ST-ELEVATION MYOCARDIAL INFARCTION: WHEN IS CORONARY ARTERY BYPASS GRAFTING NEEDED? | 202 | ||
| PERCUTANEOUS HEMODYNAMIC SUPPORT | 202 | ||
| CORONARY COMPLICATIONS AND MANAGEMENT | 203 | ||
| No-Reflow | 203 | ||
| Coronary Perforation | 203 | ||
| Stent Thrombosis: Intraprocedural and Acute | 203 | ||
| Optimal Duration of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention: Prevention of Stent Thrombosis | 204 | ||
| PRACTICAL HOSPITAL FOLLOW-UP AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION | 204 | ||
| Assessment the Day after Percutaneous Coronary Intervention | 204 | ||
| Biomarker Assessment | 204 | ||
| Management of Recurrent Chest Pain | 204 | ||
| Monitoring for Renal Dysfunction | 205 | ||
| When Is It Safe to Discharge Following ST-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Interventio... | 205 | ||
| SUMMARY | 205 | ||
| References | 205 | ||
| 18 - Clinical Practice/Controversy: SELECTION OF INITIAL ANTICOAGULANT THERAPY | 207 | ||
| Rationale for Anticoagulant Therapy in Acute Coronary Syndrome | 207 | ||
| Containing Thrombus Formation and Propagation | 207 | ||
| OVERVIEW OF AVAILABLE ANTICOAGULANT DRUGS | 207 | ||
| Unfractionated Heparin | 208 | ||
| Low–Molecular-Weight Heparins | 208 | ||
| Fondaparinux | 209 | ||
| Bivalirudin | 210 | ||
| Other Parenteral Anticoagulants | 210 | ||
| Monitoring of Available Anticoagulant Therapy | 210 | ||
| Reversal of Anticoagulant Therapy | 211 | ||
| INITIAL ANTICOAGULANT THERAPY | 211 | ||
| ST-Elevation Myocardial Infarction Treated with Primary Percutaneous Intervention | 211 | ||
| Unfractionated Heparin During Primary Percutaneous Coronary Intervention | 211 | ||
| Enoxaparin versus Unfractionated Heparin for Primary Percutaneous Coronary Intervention | 212 | ||
| Bivalirudin versus Unfractionated Heparin for Primary Percutaneous Coronary Intervention | 212 | ||
| ST-Elevation Myocardial Infarction Treated with Fibrinolysis | 213 | ||
| Unfractionated Heparin as an Adjunct to Fibrinolysis | 214 | ||
| Low–Molecular-Weight Heparin as an Adjunct to Fibrinolysis | 214 | ||
| Fondaparinux as an Adjunct to Fibrinolysis | 214 | ||
| Bivalirudin as an Adjunct to Fibrinolysis | 215 | ||
| Anticoagulant Therapy in Non–ST-Elevation Myocardial Infarction | 216 | ||
| Unfractionated Heparin in Treatment of Non–ST-Elevation Myocardial Infarction | 216 | ||
| Low–Molecular-Weight Heparin in Non–ST-Elevation Myocardial Infarction | 218 | ||
| Pharmacodynamics of Enoxaparin and the Invasive Strategy | 218 | ||
| Fondaparinux in Non–ST-Elevation Myocardial Infarction | 218 | ||
| Direct Thrombin Inhibitors | 218 | ||
| Myocardial Infarction Treated Without Reperfusion Therapy | 219 | ||
| HIGH-RISK POPULATIONS | 219 | ||
| Dose Adjustment in Older Adult Patients | 219 | ||
| Renal Insufficiency | 219 | ||
| Heparin-Induced Thrombocytopenia | 219 | ||
| SUMMARY | 219 | ||
| Classic References | 219 | ||
| References | 219 | ||
| 19 - OVERVIEW OF ANTIPLATELET THERAPY FOR MYOCARDIAL INFARCTION | 221 | ||
| INTRODUCTION | 221 | ||
| RATIONALE FOR USE OF ANTIPLATELET THERAPY | 221 | ||
| ANTIPLATELET THERAPIES IN MYOCARDIAL INFARCTION | 221 | ||
| Aspirin | 222 | ||
| P2Y12 Receptor Antagonists | 223 | ||
| Clopidogrel | 224 | ||
| Prasugrel | 224 | ||
| Ticagrelor | 227 | ||
| Cangrelor | 227 | ||
| Glycoprotein IIb/IIIa Inhibitors | 229 | ||
| Protease-Activated Receptor-1 Antagonists | 230 | ||
| PRACTICAL RECOMMENDATIONS AND GUIDELINES | 230 | ||
| Indications and Dosing of Antiplatelet Therapies | 230 | ||
| Clopidogrel | 231 | ||
| Prasugrel | 231 | ||
| Ticagrelor | 231 | ||
| Vorapaxar | 232 | ||
| Cangrelor | 232 | ||
| Timing of Administration of Antiplatelet Therapies | 232 | ||
| General Considerations | 232 | ||
| Timing of Administration of Oral P2Y12 Receptor Antagonists | 232 | ||
| Non–ST-Elevation Myocardial Infarction | 232 | ||
| ST-Elevation Myocardial Infarction | 233 | ||
| Selection of Oral P2Y12 Receptor Antagonist | 234 | ||
| Switching P2Y12 Receptor Antagonists | 234 | ||
| SUMMARY | 236 | ||
| References | 237 | ||
| 20 - Clinical Practice/Controversy: INDIVIDUALIZATION OF ANTIPLATELET THERAPY FOR PATIENTS WITH ACUTE CORONARY SYNDROMES\r | 239 | ||
| INTRODUCTION | 239 | ||
| CLOPIDOGREL METABOLISM AND BIOLOGICAL RESPONSE | 239 | ||
| METHODS FOR PLATELET FUNCTION TESTING | 239 | ||
| Vasodilator-Stimulated Phosphoprotein Phosphorylation | 240 | ||
| Multiplate Impedance Aggregometry | 240 | ||
| VerifyNow | 241 | ||
| Light Transmission Aggregometry | 241 | ||
| RATIONALE FOR PLATELET FUNCTION TESTING | 241 | ||
| Prognostic Usefulness of Platelet Function Testing for Thrombotic Events | 241 | ||
| Prognostic Usefulness of Platelet Function Testing for Bleeding Events | 242 | ||
| PLATELET FUNCTION TEST-GUIDED TREATMENT STRATEGY | 242 | ||
| Limitations of Platelet Function Testing | 243 | ||
| Seeking a Therapeutic Window of P2Y12 Inhibition | 243 | ||
| GENETIC TESTS FOR CLOPIDOGREL RESPONSE | 244 | ||
| Genotype Test-Guided Treatment Strategy | 245 | ||
| Genotype and Platelet Function Test-Guided Strategy | 245 | ||
| Genotype Test and Clinically Guided Approach | 246 | ||
| SUMMARY | 246 | ||
| References | 248 | ||
| 21 - OLD AND NEW ORAL ANTICOAGULANT THERAPY AFTER MYOCARDIAL INFARCTION | 249 | ||
| INTRODUCTION | 249 | ||
| ROLE OF THROMBIN IN ACUTE CORONARY SYNDROME | 249 | ||
| CURRENT THERAPY AND OUTCOMES FOLLOWING ACUTE CORONARY SYNDROME | 250 | ||
| VITAMIN K ANTAGONIST THERAPY AFTER MYOCARDIAL INFARCTION | 251 | ||
| NEW ORAL ANTICOAGULANT THERAPY IN STABILIZED ACUTE CORONARY SYNDROME | 251 | ||
| Initial Phase II Trials | 251 | ||
| Large Outcome Trials | 252 | ||
| Apixaban | 252 | ||
| Rivaroxaban | 252 | ||
| Specific Patient Populations | 254 | ||
| Synthesis Across Divergent Clinical Trials | 254 | ||
| CURRENT ROLE FOR ORAL ANTICOAGULATION FOR SECONDARY PREVENTION AFTER MYOCARDIAL INFARCTION | 255 | ||
| Patients with Another Indication for Oral Anticoagulant Therapy | 255 | ||
| Triple Oral Antithrombotic Therapy | 256 | ||
| Consensus Practice Guidelines | 256 | ||
| SUMMARY | 256 | ||
| References | 257 | ||
| 22 - STEM CELL THERAPY IN PATIENTS WITH MYOCARDIAL INFARCTION\r | 259 | ||
| INTRODUCTION | 259 | ||
| RATIONALE FOR CELL THERAPY IN ACUTE MYOCARDIAL INFARCTION | 259 | ||
| CELL TYPES USED FOR CELL THERAPY IN MYOCARDIAL INFARCTION | 259 | ||
| Embryonic Stem Cells | 259 | ||
| Preclinical Studies | 260 | ||
| Induced Pluripotent Stem Cells | 261 | ||
| Preclinical Studies | 261 | ||
| Barriers to Clinical Development | 261 | ||
| Bone Marrow Mononuclear Cells | 261 | ||
| Clinical Trials | 261 | ||
| REPAIR-AMI | 263 | ||
| Other Randomized Trials of Bone Marrow Mononuclear Cells | 263 | ||
| Reconciling Discordant Results from Clinical Trials | 264 | ||
| Meta-Analyses of Bone Marrow Cell Therapy | 264 | ||
| Selected Bone Marrow Cells | 266 | ||
| Mesenchymal Stromal Cells | 267 | ||
| ROUTES OF CELL DELIVERY | 267 | ||
| Intravenous Delivery | 268 | ||
| Intracoronary Delivery | 269 | ||
| Intramyocardial Injection | 269 | ||
| MECHANISM OF ACTION OF CELL THERAPY | 269 | ||
| UNMET CHALLENGES IN SUCCESSFUL TRANSLATION OF CELL THERAPY AND FUTURE DIRECTIONS | 271 | ||
| Cell Type | 271 | ||
| Cell Dose | 271 | ||
| Cell Retention | 272 | ||
| Timing of Cell Therapy | 272 | ||
| Trial Endpoints | 272 | ||
| SUMMARY | 272 | ||
| References | 272 | ||
| IV - In-Hospital Complications and Assessment | 275 | ||
| 23 - RECURRENT ISCHEMIA AND RECURRENT MYOCARDIAL INFARCTION: DETECTION, DIAGNOSIS, AND OUTCOMES\r | 275 | ||
| INTRODUCTION | 275 | ||
| DETECTION OF RECURRENT ISCHEMIA AND INFARCTION | 275 | ||
| Recurrent Ischemia Without Infarction | 275 | ||
| Diagnosis of Recurrent Myocardial Infarction | 276 | ||
| Classification of Recurrent Myocardial Infarction | 276 | ||
| Spontaneous Myocardial Infarction | 276 | ||
| Myocardial Infarction Related to Percutaneous Coronary Intervention (Type 4a) | 276 | ||
| Myocardial Infarction Caused by Stent Thrombosis (Type 4b) | 276 | ||
| Myocardial Infarction with Coronary Artery Bypass Grafting (Myocardial Infarction Type 5) | 276 | ||
| Recurrent Myocardial Infarction and the Electrocardiogram | 276 | ||
| Biomarkers and Recurrent Myocardial Infarction | 276 | ||
| Comparison of Different Definitions of Myocardial Infarction | 277 | ||
| CAUSES AND PREDICTORS OF RECURRENT MYOCARDIAL INFARCTION | 277 | ||
| Causes of Recurrent Myocardial Infarction | 277 | ||
| Predictors of Recurrent Myocardial Infarction | 277 | ||
| Recurrent Myocardial Infarction in the Culprit or Nonculprit Arteries | 278 | ||
| INCIDENCE OF RECURRENT MYOCARDIAL INFARCTION | 278 | ||
| Time Course of Recurrent Myocardial Infarction | 280 | ||
| OUTCOMES WITH RECURRENT MYOCARDIAL INFARCTION | 280 | ||
| Prognosis with Type 4a Myocardial Infarction | 282 | ||
| PREVENTION OF RECURRENT MYOCARDIAL INFARCTION | 285 | ||
| SUMMARY | 285 | ||
| References | 285 | ||
| 24 - REPERFUSION INJURY: PREVENTION AND MANAGEMENT\r | 286 | ||
| PATHOLOGICAL AND CLINICAL COMPONENTS OF REPERFUSION INJURY | 286 | ||
| Stunned Myocardium | 286 | ||
| Reperfusion Arrhythmias | 288 | ||
| No-Reflow Phenomenon and Microvascular Obstruction | 288 | ||
| Pathobiology | 288 | ||
| Clinical Manifestations | 289 | ||
| Lethal Myocardial Cell Injury Caused by Reperfusion | 289 | ||
| PREVENTION AND MANAGEMENT OF REPERFUSION INJURY | 290 | ||
| General Interventions to Manage Complications of Ischemia/Reperfusion Injury | 290 | ||
| Stunned Myocardium | 290 | ||
| Reperfusion Arrhythmias | 290 | ||
| Interventions Aimed at Reducing Microvascular Obstruction | 290 | ||
| Hypothermia | 290 | ||
| Agents Influencing Free Radicals | 290 | ||
| Interventions Aimed at Preventing Reperfusion Injury That Causes Cellular Necrosis | 290 | ||
| Postconditioning | 291 | ||
| Cyclosporin A | 291 | ||
| Bendavia | 292 | ||
| Other Pharmacotherapeutic Approaches | 292 | ||
| Hypothermia | 293 | ||
| Importance of Timing of Administration | 293 | ||
| Lessons Learned from Previous Studies | 293 | ||
| SUMMARY | 293 | ||
| References | 293 | ||
| 25 - HEART FAILURE AND CARDIOGENIC SHOCK AFTER MYOCARDIAL INFARCTION\r | 295 | ||
| INTRODUCTION | 295 | ||
| Defining and Classifying Heart Failure and Cardiogenic Shock | 295 | ||
| EPIDEMIOLOGY AND OUTCOMES | 296 | ||
| Incidence and Risk Factors | 296 | ||
| Outcomes with Heart Failure and Cardiogenic Shock | 296 | ||
| Mortality Risk Prediction | 297 | ||
| PATHOPHYSIOLOGY | 297 | ||
| Hemodynamic Considerations | 297 | ||
| Impact of Altered Hemodynamics | 299 | ||
| Vasodilatory and Inflammatory Response in Cardiogenic Shock | 300 | ||
| PRESENTATION AND INITIAL EVALUATION | 300 | ||
| Presentation of Heart Failure and Cardiogenic Shock After Myocardial Infarction | 300 | ||
| Differential Diagnosis | 300 | ||
| Approach to Evaluation of a Patient with Shock | 301 | ||
| Clinical History and Physical Examination | 301 | ||
| Laboratory Assessments | 301 | ||
| Echocardiography | 301 | ||
| Cardiovascular Magnetic Resonance | 302 | ||
| Invasive Coronary Angiography | 302 | ||
| Hemodynamic Monitoring | 303 | ||
| MANAGEMENT OF HEART FAILURE AND SHOCK DUE TO IMPAIRED VENTRICULAR CONTRACTILITY | 303 | ||
| General Principles of Management | 303 | ||
| Coronary Reperfusion and Revascularization | 303 | ||
| Timing of Revascularization in Shock | 304 | ||
| Method of Reperfusion | 305 | ||
| Non–Culprit Artery Revascularization in Shock | 307 | ||
| Pharmacotherapy | 307 | ||
| Vasoactive Medications | 307 | ||
| General Considerations | 307 | ||
| Norepinephrine | 308 | ||
| Epinephrine | 308 | ||
| Phenylephrine | 310 | ||
| Vasopressin | 310 | ||
| Inotropes | 310 | ||
| Vasodilators | 310 | ||
| Volume Management | 310 | ||
| β-Adrenergic Blockers | 311 | ||
| Investigational Agents | 311 | ||
| Mechanical Circulatory Support | 312 | ||
| SUMMARY | 312 | ||
| References | 312 | ||
| 26 - MECHANICAL COMPLICATIONS OF MYOCARDIAL INFARCTION\r | 314 | ||
| INTRODUCTION | 314 | ||
| RIGHT VENTRICULAR INFARCTION | 314 | ||
| Diagnosis of Right Ventricular Infarction | 314 | ||
| Physical Examination in Right Ventricular Infarction | 314 | ||
| Electrocardiography of Right Ventricular Infarction | 315 | ||
| Hemodynamics in Right Ventricular Infarction | 315 | ||
| Echocardiography of Right Ventricular Infarction | 315 | ||
| Prognosis with Right Ventricular Infarction | 315 | ||
| Treatment of Right Ventricular Infarction | 316 | ||
| MECHANICAL COMPLICATIONS OF MYOCARDIAL INFARCTION | 318 | ||
| Left Ventricular Free-Wall Rupture | 318 | ||
| Pseudoaneurysm | 319 | ||
| Ventricular Septal Rupture | 319 | ||
| Repair of Ventricular Septal Rupture: Timing and Approaches | 322 | ||
| Acute Mitral Regurgitation | 323 | ||
| Left Ventricular Aneurysm | 324 | ||
| LEFT VENTRICULAR THROMBUS | 325 | ||
| References | 326 | ||
| 27 - Clinical Practice/Controversy: MECHANICAL CIRCULATORY SUPPORT FOR COMPLICATIONS OF MYOCARDIAL INFARCTION: ROLE OF CURRENTLY AVAILABLE DEVICES | 327 | ||
| INTRODUCTION | 327 | ||
| MECHANICAL CIRCULATORY SUPPORT DEVICES | 327 | ||
| Intra-Aortic Balloon Pump | 327 | ||
| Hemodynamic Effects | 327 | ||
| Clinical Use | 329 | ||
| Observational Evidence | 330 | ||
| Randomized Trials | 331 | ||
| TandemHeart | 331 | ||
| Hemodynamic Effects | 331 | ||
| Clinical Use | 332 | ||
| Clinical Trial Evidence | 333 | ||
| Impella | 333 | ||
| Hemodynamic Effects | 333 | ||
| V - Discharge and Beyond | 419 | ||
| 34 - NEW CONCEPTS IN CARDIAC REHABILITATION AND SECONDARY PREVENTION AFTER MYOCARDIAL INFARCTION\r | 419 | ||
| INTRODUCTION | 419 | ||
| EVIDENCE FOR CARDIAC REHABILITATION AND SECONDARY PREVENTION | 420 | ||
| COMPONENTS OF CARDIAC REHABILITATION AND SECONDARY PREVENTION | 421 | ||
| Systematic Referral | 421 | ||
| Patient Risk Assessment and Tailored Planning | 422 | ||
| Exercise Testing and Training | 423 | ||
| Education | 423 | ||
| Psychosocial Support | 423 | ||
| Comprehensive Risk Factor Management | 427 | ||
| Physical Activity Counseling | 427 | ||
| Smoking Cessation | 427 | ||
| Nutritional Counseling and Weight Management | 428 | ||
| Hyperlipidemia and Lipid Control | 428 | ||
| Management of Hypertension | 429 | ||
| Cardioprotective Medications and Adherence | 429 | ||
| Antiplatelet Therapy | 429 | ||
| Inhibitors of the Renin-Angiotensin-Aldosterone System | 429 | ||
| β-Adrenergic Blockers | 429 | ||
| Adherence to Therapy | 430 | ||
| CURRENT CHALLENGES IN CARDIAC REHABILITATION AND SECONDARY PREVENTION | 430 | ||
| Patient Subgroups with Specific Needs | 430 | ||
| Heart Failure | 430 | ||
| Diabetes | 430 | ||
| Elderly Persons | 431 | ||
| Women | 431 | ||
| Maintaining Long-Term Behavior Change | 431 | ||
| Quality Assurance | 431 | ||
| The Role of the Cardiologist | 432 | ||
| Innovative Models of Rehabilitation and Prevention | 432 | ||
| SUMMARY | 432 | ||
| Classic References | 432 | ||
| References | 432 | ||
| 35 - Clinical Practice/Controversy:ANTIPLATELET THERAPY AFTER MYOCARDIAL INFARCTION | 434 | ||
| EPIDEMIOLOGY OF RECURRENT ATHEROTHROMBOSIS | 434 | ||
| Myocardial Infarction as a Marker of Long-Term Atherothrombotic Risk | 434 | ||
| Types of Atherothrombotic Events in Stable Patients with Previous Myocardial Infarction | 435 | ||
| Rationale for Antiplatelet Therapy for Long-Term Secondary Prevention | 437 | ||
| CLINICAL TRIALS OF ANTIPLATELET THERAPY FOR SECONDARY PREVENTION AFTER MYOCARDIAL INFARCTION | 437 | ||
| Aspirin | 437 | ||
| P2Y12 Inhibitors | 437 | ||
| CHARISMA Trial | 437 | ||
| DAPT Trial | 439 | ||
| PEGASUS-TIMI 54 Trial | 440 | ||
| Pooled Analysis of P2Y12 Trials | 440 | ||
| Protease-Activated Receptor Antagonists | 440 | ||
| Bleeding with Long-Term Antiplatelet Therapy | 442 | ||
| Summary Across Trials | 442 | ||
| Withdrawal of Antiplatelet Therapy in Patients with Previous Myocardial Infarction | 443 | ||
| Patient Selection: Subgroups and Risk Stratification | 444 | ||
| Risk Scores | 444 | ||
| PRACTICAL APPROACH TO ANTIPLATELET THERAPY AFTER MYOCARDIAL INFARCTION | 445 | ||
| Patients Within 1 Year from the Most Recent Myocardial Infarction | 445 | ||
| Patients at 1 Year from Myocardial Infarction | 447 | ||
| Patients Beyond 1 Year from Myocardial Infarction | 447 | ||
| When to Stop P2Y12 Inhibitor or Protease-Activated Receptor 1 Antagonist Therapy | 447 | ||
| SUMMARY | 447 | ||
| References | 447 | ||
| 36 - TACKLING THE PROBLEM OF ADVERSE VENTRICULAR REMODELING AFTER MYOCARDIAL INFARCTION\r | 449 | ||
| INTRODUCTION | 449 | ||
| DEFINITION OF ADVERSE VENTRICULAR REMODELING | 449 | ||
| CELLULAR AND MOLECULAR MECHANISMS | 451 | ||
| Cardiomyocytes | 451 | ||
| Endothelial Cells | 452 | ||
| Fibroblasts | 452 | ||
| Leukocytes | 452 | ||
| DETERMINANTS OF ADVERSE VENTRICULAR REMODELING | 453 | ||
| Timely Reperfusion and “No Reflow” | 453 | ||
| Delayed Reperfusion and the “Open Artery Hypothesis” | 454 | ||
| Hypertrophic Response | 454 | ||
| Cell Death, Senescence, and Regeneration | 454 | ||
| Fibrotic Response | 455 | ||
| Afterload, Preload, and Wall Stress | 455 | ||
| Neurohormonal Activation | 455 | ||
| Inflammation | 455 | ||
| Cardiac Electrical and Neuroautonomic Remodeling | 456 | ||
| TACKLING ADVERSE VENTRICULAR REMODELING IN CLINICAL PRACTICE | 456 | ||
| Guideline-Recommended Medical Therapy | 457 | ||
| Angiotensin and Aldosterone Blockers | 457 | ||
| β-Adrenergic Blockers | 458 | ||
| Other Pharmacologic Therapies | 458 | ||
| ONGOING CLINICAL AND TRANSLATIONAL RESEARCH | 458 | ||
| Anti-Inflammatory Therapies | 458 | ||
| Nonsteroidal Anti-Inflammatory Drugs | 459 | ||
| Complement Cascade | 459 | ||
| Cytokines | 459 | ||
| Metalloproteinases | 459 | ||
| Immunoglobulin Therapy | 459 | ||
| Growth Factors | 459 | ||
| Cardiac Regeneration | 460 | ||
| Cardiac Diastolic Constraining Devices | 460 | ||
| Biologic Scaffolds | 461 | ||
| SUMMARY | 461 | ||
| Classic Reading List | 461 | ||
| References | 461 | ||
| Index | 462 | ||
| A | 462 | ||
| B | 463 | ||
| C | 463 | ||
| D | 464 | ||
| E | 464 | ||
| F | 464 | ||
| G | 464 | ||
| H | 464 | ||
| I | 464 | ||
| J | 465 | ||
| K | 465 | ||
| L | 465 | ||
| M | 465 | ||
| N | 466 | ||
| O | 466 | ||
| P | 466 | ||
| R | 466 | ||
| S | 467 | ||
| T | 467 | ||
| U | 467 | ||
| V | 467 | ||
| W | 468 | ||
| X | 468 | ||
| IBC | ES2 |