The first edition of this text was published in 2003 when
acute coronary syndrome had become a well-defined clinical
entity decades after clinical observations on premonitory
symptoms preceding myocardial infarction and sudden
death. The syndrome demarcates the acute unstable life-
threatening manifestations of coronary atherosclerosis from
the silent/stable manifestations of the disease. The bridge
between the two conditions is the unstable plaque; diagnostic
clues to the presence of such plaques are progressive angina,
ST-T changes, and cardiac troponin elevation, all indicators
of evolving ischemia. The opportunity to recognize patients
at risk and prevent myocardial infarction and cardiac death
set the stage for a wealth of fundamental and clinical research
on the epidemiology and pathophysiology of dynamic atherosclerosis. It set a model for testing interventions aimed
at preventing progression of the disease taking profit from
the art of clinical trials being in full expansion. The sample
size and event rates were there. Patients with chest pain and
acute coronary syndromes indeed populated emergency
departments and coronary care units, carrying a high-risk
of acute ischemic events and recurrence of an event in the
following months. Accordingly, the first edition of this text
was mainly didactic and focused on prevalence, pathophysiology, diagnostic methods, and medical management and
interventional procedures. It also included coverage of sub-
groups, secondary prevention, and guidelines recommendations for management.
Download here: Acute Coronary Syndrome
Download here: Acute Coronary Syndrome
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