Antiplatelet Therapy in Clinical Practice
James A. Ferguson III, Nicolas A.F. Chronos, and Robert A. Harrington. 353 pp. London, England: Martin Dunitz; 2000. $99.95. ISBN 1-85317-624-9.
The prominent role of the platelet-rich thrombus in the clinical manifestations of atherosclerotic disease has been well recognized now for several decades. Because until relatively recently our antiplatelet armamentaria was limited essentially to aspirin alone, there was little need for a textbook to address antiplatelet therapies. Over the last 5 to 7 years, however, the number and classes of available antiplatelets have increased dramatically. Along with this has come a significant advance in our understanding and, perhaps more importantly, our appreciation for the role of antiplatelet therapies in the acute and chronic treatment of atherosclerotic disease. Antiplatelet Therapy in Clinical Practice is the first text to specifically address the various aspects of antiplatelet therapy that are necessary to fully understand and truly appreciate the current and future role of antiplatelet therapies in the practice of clinical medicine.
The editors have organized the contributions of 36 authors, most of whom are recognized leaders in their field, into 4 broad sections. The first section provides a basic background of the thrombotic process, with excellent overviews of the coagulation cascade and platelet function. It provides a thorough background of the thrombotic process and platelet physiology on which the following chapters build. The second section is composed of 6 chapters, each dedicated to the pharmacology and clinical studies of specific antiplatelet agents. There is a chapter on aspirin and dipyridamole, another on the thienopyridines ticlopidine and clopidogrel, and separate chapters on the glycoprotein IIb/IIIa inhibitors, both parenteral and oral. The third section addresses the clinical application of these agents. Individual chapters thoroughly discuss the more common applications of antiplatelet therapies (ie, for acute coronary syndromes and with percutaneous coronary interventions). Other, less well-recognized clinical applications of antiplatelet therapy (ie, peripheral vascular disease and atrial fibrillation) are also covered in individual chapters. The final section addresses the future directions of antiplatelet therapy in 3 chapters. Overall, the book is well organized, which allows for a quick review of a specific antiplatelet agent or of all antiplatelet therapies in a specific clinical diagnosis. It is also relatively easy to read cover-to-cover as a primer on antiplatelet therapies.
As with any book written by multiple authors, some overlap of discussion occurs between the different chapters. However, this does not diminish from the book’s usefulness as a resource, and it allows the reader to receive an all-inclusive review of a specific topic by reading just 1 chapter rather than skipping through various sections of the book. Figures, tables, and charts are amply used and help explain and put into perspective difficult concepts and summarize large amounts of data. Although several chapters would benefit from further discussion of their topic, overall, for a first effort in an area as rapidly changing as antiplatelet therapies, the book is very inclusive.
Antiplatelet Therapy in Clinical Practice is a book that has been needed for several years. It is an excellent resource for any physician who frequently uses antiplatelet agents. Although written primarily by and for cardiologists, the book will also prove to be a valuable reference for internists, house staff, and medical students.
- Copyright © 2000 by American Heart Association