Textbook of Interventional Cardiovascular Pharmacology PDF

Preface

The last quarter of a century has seen dramatic developments in the management of cardiovascular diseases. Besides the pioneering developments in the medical management of cardiovascular disorders the field of interventional cardiology has also emerged as a major discipline with a huge impact on the clinical management of acute coronary syndrome, chronic coronary artery disease, congestive heart failure, and peripheral vascular and valvular diseases. Percutaneous interventions necessitated the development of newer agents and drugs for the imaging, anticoagulation, vascular tone control, and post-interventional proliferative control processes. Drug coating of mechanical devices posed yet another challenge in addressing the safety issues related to these modified devices.

The last decade has witnessed a major breakthrough in the use of mechanical support devices such as stents and newer drugs, which has revolutionized the field of interventional cardiology. Moreover, novel uses of drugs, such as drug-coated stents and grafts have emerged. While conventional drugs, such as aspirin, heparin, and clopidrogel, are commonly used in the short-and long-term treatment of patients who have undergone interventions, many newer drugs and drug combinations have been developed.

provide a comprehensive coverage of pharmacologic agents which are currently used and for those that are in clinical trials and will soon become available for clinical use. The use of drugs for the acute and extended indications in this area is in transition. The recommendations from peer groups undergo periodic revisions due to the introduction of newer devices and/or newer drugs. Thus, it provides a moving target to develop guidelines. This book is intended to provide some of the fundamental knowledge as a foundation to appreciate the ongoing developments in the area of interventional sciences.

The molecular and cellular understanding of the pathogenesis of cardiovascular diseases, in particular acute coronary syndromes, and the use of interventional procedures in their management has identified several newer targets to optimize clinical management of patients undergoing these procedures. In the area of newer drugs developed in conjunction with interventional procedures, progress has been remarkable and there has been an influx of massive information on their pharmacology and toxicology. Recognizing the importance of this developing area and its impact on interventional cardiology practice, the editors identified the need of a comprehensive reference book covering this topic. Having such information in one volume is projected to meet the need of practicing interventional cardiologists to obtain objective knowledge of the newer drugs used in interventional cardiology. It is hoped that this book will provide a comprehensive coverage of pharmacologic agents which are currently used and for those that are in clinical trials and will soon become available for clinical use. The use of drugs for the acute and extended indications in this area is in transition. The recommendations from peer groups undergo periodic revisions due to the introduction of newer devices and/or newer drugs. Thus, it provides a moving target to develop guidelines. This book is intended to provide some of the fundamental knowledge as a foundation to appreciate the ongoing developments in the area of interventional sciences.

This book is comprised of over fifty chapters, each of which is written by an expert in the assigned topic. Assembling a multi-authored specialized pharmacology book is a major challenge for both the authors and the editors. Because of the influx of newer information, differing opinions, data interpretation and regulatory positions, the authors are challenged to provide the most practical, unbiased and helpful information on specific topics. The editors are grateful to the authors contributing to this book for their excellent and objective manuscripts which are written in an integrated fashion to provide an updated and comprehensive account of different drugs and devices.

This book is divided into five parts comprised of systemic and endoluminal therapy, local therapy, therapeutic angiogenesis, adjunctive pharmacotherapy and noncoronary interventions. The first chapter is on hemostasis and thrombosis and is included since many of the new drugs target the components of the hemostatic system including cellular sites and receptors on platelets, endothelial cells, white cells and blood proteins. The last chapter is written as an epilogue to provide an objective opinion on current drug development in vascular medicine and interventions. It is hoped that the individual chapters included will provide updated references to practicing clinicians and those who are involved in the development of newer drugs.

This book is also intended to serve as a comprehensive reference and a practical guide in the application of drugs and devices used for primary coronary angioplasty, coronary thrombolysis and the correction in ST segment elevation in acute coronary syndrome. Specialized topics such as drug coated stents, molecular therapies, cellular therapies, newer pharmacologic approaches and specific topics on noncoronary interventions are also reported. It is hoped that this book will be periodically updated to reflect the ongoing developments in this fast moving area.