(Circulation. 2008;118:e667.)
© 2008 American Heart Association, Inc.
Book Review |
Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC
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Clinical Guide to the Use of Antithrombotic Drugs in Coronary Artery Disease, edited by Angiolillo, Kastrati, and Simon, is a well written, carefully planned, timely, and contemporary review of the use of antithrombotic drugs in the context of coronary artery disease. The book is very logically divided into 3 major sections: 1) Basic Concepts of Atherothrombosis; 2) Antithrombotic Drugs, which is itself divided into subsections on oral antiplatelet drugs, intravenous antiplatelet drugs, thrombin inhibitors, and thrombin generation inhibitors and fibrinolytic therapy; and 3) Special Situations. Each section acknowledges and discusses in a practical way the challenges faced regularly by clinicians committed to translating constructs of fundamental pathobiology and the results of clinical trials effectively to evidence-based care of patients with atherothrombotic coronary artery disease.
Despite the books multiple contributors, the editors have encouraged and fostered a highly integrated approach from a respected and internationally recognized group of clinician-scientists. The result is a seamless transition from pathobiology and translational science to pharmacology and clinical application. The text format, tables, and figure layout are clear and concise and appropriately inform the text. A minor esthetic distraction and deviation from an overall highly consistent presentation is the use of Power Point slides for figures in several of the 28 chapters and within the color plate section.
Recognizing the challenges of assembling and coordinating the literary efforts of nearly 60 contributing authors from around the world in an expeditious manner, Drs Angiolillo, Kastrati, and Simon deserve accolades for navigating and ultimately crafting a comprehensive, up-to-date, and scholarly text that is targeted to the clinician faced with practical decision making that nonetheless requires a rigorous knowledge base. Although the content is highly pertinent to current clinical practice, a number of topics of current and future interest were not included. These include intravenous and oral platelet P2Y12 receptor antagonists, emerging oral antithrombins, synthetic heparin mimetics and optimized molecules, RNA aptamer-antidote anticoagulants, pharmacogenomics, and the highly complex yet relevant topics of coronary artery protection (proximal, distal) and extracorporeal circulatory devices (eg, cardiopulmonary bypass, intraaortic balloon pumps, and other hemodynamic support systems and ventricular assist modalities). These rapidly evolving areas within the ever-expanding universe of thrombocardiology, as well as further dedication to coronary artery stenting, in particular the biological–nonbiological pharmacology interface and novel drug delivery systems, should be considered if subsequent editions are undertaken.
Despite these omissions, the editors have established a platform to fulfill their major goal, to "understand the basic principles of atherothrombosis, as well as the pharmacological agents currently available or under clinical development." I believe that this highly laudable objective has in large measure been achieved. This volume should be of considerable value to the cardiology community as well as to noncardiologists who manage patients with coronary artery disease. In light of the rapid and sometimes confusing change in this area, this work will also contribute in a meaningful way to optimizing healthcare. Accordingly, Clinical Guide to the Use of Antithrombotic Drugs in Coronary Artery Disease is now, and will remain, a book in my personal library.
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