Management of Acute Coronary Syndromes, 2d ed.
Christopher P. Cannon, MD, ed.
Totowa, NJ: Humana Press; 2003. Available in hard cover (800 pp; $135.00; ISBN 1-58829-130-8), paperback (792 pp; $99.50; ISBN 1-58829-309-2), and eBook (7432 kb; $120.00; ISBN 1-59259-351-8).
The old adage “If you don’t like the weather, just wait a while and it will change” could be equally well applied to the rapid changes in the treatment of patients with an acute coronary syndrome (ACS). Today, it is virtually impossible to open any issue of any general cardiology journal without finding at least one article directed at some aspect of the ACS. Because of the enormous volume of mechanistic and clinical trials focusing on this population, it has become difficult for the practicing physician just to remain current and virtually impossible to fully understand all of the subtle nuances of the available data. This is why an up-to-date, comprehensive, and expert review of all aspects of the diagnosis and treatment of the ACS patient is such an essential resource for any patient-care provider involved in the management of these patients. The second edition of Management of Acute Coronary Syndromes is just such a resource.
Many of the most respected authorities in the field of cardiology, and specifically ACS, are first or senior authors for the 27 chapters of the book. Each chapter focuses on a precise, pertinent topic central to the diagnosis and management of patients with an ACS. The relatively large number of chapters for such a narrow diagnosis as ACS allows for the comprehensive review of many topics not frequently covered in such detail. For example, triggers of ACS, myocardial perfusion grading, management issues in community hospitals, ACS in women and young patients, smoking cessation, cost-effectiveness, and critical pathways are all covered in great detail in focused chapters.
The book is divided into five major sections: “Pathophysiology,” “Diagnosis,” “ST-Segment Elevation Myocardial Infarction,” “Non-ST-Segment Myocardial Infarction,” and the catchall “Special Aspects of Acute Coronary Syndromes.” Not only does such a division better reflect our current understanding of the ACS patient, but also, for the reader seeking a complete understanding of any one area, it makes it easier to digest the 4 to 8 chapters specific to that topic. Alternatively, each chapter can also be read as a stand-alone, thorough, but still concise review of a specific topic.
A limitation of any multi-authored book, especially one focused on a limited area such as ACS, is substantial overlap of a topic between authors. For example, the role of serum markers in the diagnosis and risk stratification of patients is discussed in some detail in the 5th, 6th, 7th, 8th, 15th, and 18th chapters. In some ways this can be helpful when the reader has time to digest just one chapter and wants all aspects covered; on the other hand, when authors are allowed such wide latitude to stray from their specific topic, important aspects of that topic can be missed. For example, there is almost no mention in the book of the role of brain natriuretic peptide levels in the risk stratification and treatment of ACS patients. Likewise, although the terms “Killip class” and “hemodynamic class” are used in various locations throughout the book, if a reader were unfamiliar with these terms, he or she would not be able to find a suitable definition. Overall, however, these are just minor annoyances and do not significantly detract from the usefulness of the book.
Although the paperback version of the book is too large for the pocket of a laboratory coat, it is well sized for toting around between the coronary intensive care unit, catheterization laboratory, emergency room, and office. The typeface is easy to read, even in the middle of the night in a poorly lit call room, and all of the chapters are full of supportive graphics and illustrations. Each chapter is extensively referenced, allowing the interested reader to more deeply explore the source data.
In the preface to the second edition of Management of Acute Coronary Syndromes, the editor, Chris Cannon, states, “It is hoped that this compilation of the latest information will facilitate improvement in the management of patients with acute coronary syndromes.” By providing a comprehensive, state-of-the-art review of the pertinent aspects of the diagnosis and management of ACS patients in an easy-to-read amd easy-to-reference format, he and his outstanding collection of authors have accomplished this goal.