Cardiovascular Therapeutics E-Book : A Companion to Braunwald's Heart Disease

Manage cardiovascular problems more effectively with the most comprehensive resource available! A trusted companion to Braunwald's Heart Disease, Cardiovascular Therapeutics, 4th Edition addresses pharmacological, interventional, and surgical management approaches for each type of cardiovascular disease. This practical and clinically focused cardiology reference offers a balanced, complete approach to all of the usual and unusual areas of cardiovascular disease and specific therapies in one concise volume, equipping you to make the best choices for every patient.Consult this title on your favorite e-reader with intuitive search tools and adjustable font sizes. Elsevier eBooks provide instant portable access to your entire library, no matter what device you're using or where you're located.Understand current approaches to treating and managing cardiovascular patients for long-term health, for complex problems, and for unusual cardiac events.Benefit from the substantial experience of Elliott M. Antman, MD, Marc S. Sabatine, MD, and a host of other respected authorities, who provide practical, evidence-based rationales for all of today's clinical therapies.Expand your knowledge beyond pharmacologic interventions with complete coverage of the most effective interventional and device therapies being used today.Easily reference Braunwald's Heart Disease, 9th Edition for further information on topics of interest.Make the best use of the latest genetic and molecular therapies as well as advanced therapies for heart failure.Cut right to the answers you need with an enhanced focus on clinically relevant information and a decreased emphasis on pathophysiology.Stay current with ACC/AHA/ESC guidelines and the best ways to implement them in clinical practice.Get an enhanced visual perspective with an all-new, full-color design throughout. Inside cover Copyright page Dedication Contributors Foreword Preface Acknowledgments Look for these other titles in the Braunwald Heart Disease family Part I: Decision Making and Therapeutic Strategies in Cardiovascular Medicine Chapter 1: Tools for Assessment of Cardiovascular Tests and Therapies Interpretation of Diagnostic Tests Clinical Trials Need for Clinical Trials Clinical Trial Design Randomized Controlled Trials Nonrandomized Concurrent Control Studies Historic Controls Crossover Design Withdrawal Studies Factorial Design Trials that Test Equivalence of Therapies Selection of Endpoint Sample Size Estimations and Sequential Stopping Boundaries False-Positive and False-Negative Error Rates and Power of Clinical Trials How to Read and Interpret a Clinical Trial Missing Data Measures of Treatment Effect Detection of Treatment Effects in Clinical Trials Meta-Analysis Principles of Pooling Studies Cumulative Meta-Analysis Meta-Regression Future Trends in Meta-Analysis How to Read and Interpret a Meta-Analysis Comparative Effectiveness Research Methods for Comparative Effectiveness Research Balancing Risks and Benefits Cost-Effectiveness Analysis Types of Economic Evaluation Methods for Performing a Cost-Effectiveness Analysis Trial-Based Analyses Modeling Approaches Hybrid Approaches Other Methodologic Considerations Sensitivity Analysis Perspective Discounting Time Horizon Defining When a Therapy Is Cost Effective How to Read an Economic Evaluation References Chapter 2: New Drug Development Overview of the Drug Development Process Phase I to IV Paradigm Cycle of New Therapeutic Development Regulation of New Drugs: Prototypical Interface with the Food and Drug Administration Before the Investigational New Drug Application Types of Investigational New Drug Application Advisory Panels Labeling Postmarketing Surveillance Exemptions from Investigational New Drug Application and Practice of Medicine Investigator-Initiated Investigational New Drug Application CDER Versus CBER: Key Differences for Biologics International Drug Development Overview Ethics of Drug Development in Developing Countries Anatomy of a Clinical Trial: Operations Protocol Development Site Management Data Management Statistics Safety Surveillance Clinical Events Adjudication Economics of New Drug Development Prescription Drug User Fee Act National Institutes of Health Roadmap Program Patent Considerations Summary References Chapter 3: Device Development for Cardiovascular Therapeutics: Overview Medical Device Development and Differences from Drugs Development and Implementation of Cardiovascular Medical Devices: An Overview Differences Between Devices and Drugs and Associated Regulatory Implications Regulatory Fundamentals History of Device Regulation and the Medical Device Classification System Pathways for Regulatory Review of Cardiovascular Devices 510k Premarket Notification Premarket Approval Application Investigational Device Exemption Humanitarian Device Exemption Contemporary Regulatory Issues Randomized Versus Nonrandomized Studies in Medical Device Evaluation Endpoints and Surrogate Endpoints in Cardiovascular Device Trials Study Blinding in Cardiovascular Device Trials Use of Foreign Data for U.S. Product Approval Independent Oversight of Cardiovascular Device Trials Labeling and Off-Label Use of Cardiovascular Devices Risk, Benefit, and the Product Life Cycle Total Product Life Cycle Approach Device Safety and Failure Concepts Ensuring the Safety of Marketed Devices Postmarket Safety Assessment Tools Cardiologists’ Role in Ensuring Device Safety and Performance Product Recall and Center for Devices and Radiological Health Other Key Regulatory Topics Combination Products Role of the Advisory Panel CDRH Interactions with External Stakeholders and Government Partners References Chapter 4: Pharmacogenetics Clopidogrel Drug, Indications, Mechanism of Action, and Pharmacology Drug Interactions Pharmacogenetics of Clopidogrel Therapy CYP2C19 ABCB1 PON1 Therapeutic Implications Pharmacogenetic Testing in Clopidogrel Therapy Therapeutic modifications Cost Effectiveness of Clopidogrel Pharmacogenetics Testing Future Directions Warfarin Drug, Indications, Mechanism of Action, and Pharmacology Drug Interactions Pharmacogenetics of Warfarin Therapy VKORC1 CYP2C9 CYP4F2 Therapeutic Implications Pharmacogenetic Testing in Warfarin Therapy Cost Effectiveness of Warfarin Pharmacogenetics Testing Therapeutic Modifications Future Directions Statins Drug, Indications, Mechanism of Action, and Pharmacology Drug Interactions Pharmacogenetics of Statin Therapy Key Genetic Variants Affecting Statin Efficacy APOE PCSK9 HMGCR CETP LDLR KIF6 Genome-Wide Association Studies of Statin Response Key Genetic Variants Affecting Statin Adverse Effects SLCO1B1 Therapeutic Implications Future Directions References Chapter 5: Systems of Health Care Systems Theory Why Systems of Care Are Needed Experience to Date with Cardiovascular Systems of Care ST-Segment Elevation Myocardial Infarction Prehospital Diagnosis, Catheterization Laboratory Activation, and Transport to Primary Percutaneous Coronary Intervention Centers Regional Transfer Protocols State Systems for ST-Segment Elevation Myocardial Infarction CARE Mission: Lifeline Program to Improve ST-Segment Elevation Myocardial Infarction CARE Heart Failure Cardiac Arrest Quality Improvement Theory Experience to Date with Cardiovascular Quality Improvement ST-Segment Elevation Myocardial Infarction American College of Cardiology Door-to-Balloon Alliance CRUSADE Initiative Get with the Guidelines?Coronary Artery Disease Program Acute Coronary Treatment and Intervention Outcomes Network Heart Failure Out-of-Hospital Cardiac Arrest Lessons Learned References Chapter 6: Global Cardiovascular Therapy Introduction to Global Challenges in Cardiovascular Disease Therapy Burden of Cardiovascular Disease Current Trends and Challenges Acute Management and Secondary Prevention Acute Coronary Syndrome Secondary Prevention Challenges to Therapeutic Usage Current State of cardiovascular disease Drug Availability and Affordability in Low- and Middle-Income Countries Role of the World Health Organization Essential Drug List Human Resources Shortages Primary Prevention Polypill Population Strategies Risk Factors for Cardiovascular Disease Tobacco Blood Pressure Lipids Obesity Summary References Part II: Ischemic Heart Disease Chapter 7: Pharmacologic Options for Treatment of Ischemic Disease Organic Nitrates Overview Mechanisms of Action Pharmacokinetics Pharmacodynamic Effects Side Effects of Organic Nitrates Clinical Efficacy of Organic Nitrates Sublingual Nitrates Long-Acting Nitrates Congestive Heart Failure Other Nitrate Indications Nitrate Tolerance Biotransformation Hypothesis Neurohormonal Hypothesis Free Radical Hypothesis Nonhemodynamic Effects of Organic Nitrates Current Perspectives on Therapy with Organic Nitrates Calcium Channel Blockers Fundamental Mechanisms of Calcium Channel Blockers Calcium Channel as Site of Action Molecular Structure Drug Binding Sites Calcium Channels: L and T Types Pharmacologic Properties of Calcium Channel Blockers Pharmacodynamic Effects Major Cardiovascular Actions of Calcium Channel Blockers Classification of Calcium Channel Blockers Vascular Selectivity Noncardiovascular Effects Pharmacokinetics Major Indications for Calcium Channel Blockers Systemic Hypertension Angina Pectoris Supraventricular Tachycardia Postinfarct Protection Specific Calcium Channel Blockers Verapamil Pharmacokinetics Dose Oral Preparations Intravenous Use Side Effects Contraindications Pregnancy Diltiazem Pharmacokinetics Dose Side Effects Contraindications Pregnancy Dihydropyridines First-Generation Dihydropyridines Contraindications and Cautions Side Effects Pregnancy Second-Generation Calcium Channel Blockers Drug Interactions of Calcium Channel Blockers β-Blockers Digoxin Diltiazem Dihydropyridines Calcium Channel Blockers: The “Safety? Controversy β-Adrenergic Blockers β-Adrenergic Receptors Effects in Angina Pectoris Comparison with Other Antianginal Therapies Angina at Rest and Vasospastic Angina Combined Use of β-Blockers with Other Antianginal Therapies in Angina Pectoris Nitrates Calcium Channel Blockers Ranolazine Conditions Associated with Angina Pectoris Arrhythmias Hypertension Survivors of Acute Myocardial Infarction “Silent? Myocardial Ischemia Other Cardiovascular Conditions Associated with Angina Pectoris Hypertrophic Cardiomyopathy Congestive Cardiomyopathy Mitral Valve Prolapse Dissecting Aneurysms Ehlers-Danlos Syndrome Syndrome X Perioperative Therapy in High-Risk Patients with Ischemic Heart Disease Pharmacologic Differences Among β-Adrenergic Receptor–Blocking Drugs Potency β1 Selectivity Intrinsic Sympathomimetic Activity Partial Agonist Activity α-Adrenergic Activity Nitric Oxide Potentiating Effect Pharmacokinetics Adverse Effects of β-Adrenergic Receptor Blockers Contraindications to β-Adrenergic Receptor Blockers Overdosage β-Adrenergic Receptor Blocker Withdrawal Drug-Drug Interactions Newer Options for Treatment of Chronic Angina Nicorandil Ivabradine Ranolazine Mechanism of Action Other Potential Uses of Ranolazine Trimetazidine Thrombosis and Ischemic Cardiovascular Heart Disease Antiplatelet Therapy Aspirin Mechanisms of Action Indication Dosages Side Effects and Contraindications P2Y12 Receptor Antagonists Mechanisms of Action Indication Dosages Side Effects and Contraindications Glycoprotein IIb/IIIa Receptor Antagonists Mechanisms of Action Indications Dosages Side Effects and Contraindications Novel Antiplatelet Agents Anticoagulant Therapy Unfractionated Heparin Mechanisms of Action Indications Dosages Side Effects and Contraindications Low-Molecular-Weight Heparin Mechanisms of Action Indications Dosages Side Effects and Contraindications Direct Thrombin Inhibitors Hirudin Lepirudin Mechanisms of Action Indications and Dosages Side Effects and Contraindications Argatroban Mechanisms of Action Indications Dosages Side Effects and Contraindications Bivalirudin Hirulog Mechanisms of Action Indications and Dosage Factor Xa Inhibitors Fondaparinux Mechanisms of Action Indications and Dosages Oral Anticoagulants Warfarin Mechanisms of Action Indications Dosages Side Effects and Contraindications Novel Anticoagulant Agents Fibrinolytics Mechanisms of Action Indications Dosages Side Effects and Contraindications References Chapter 8: Stable Ischemic Heart Disease/Chronic Stable Angina Epidemiology Natural History Assessment and Investigation Clinical Assessment Risk Stratification Clinical Indicators Noninvasive Evaluation Electrocardiogram Echocardiography Cardiac Magnetic Resonance Imaging Myocardial Perfusion Scintigraphy Computed Tomography Coronary Calcium Score Computed Tomography Coronary Angiography Selection and Frequency of Noninvasive Stress Testing Invasive Evaluation Overall Assessment of Risk Therapeutic Interventions Lifestyle and Risk Factor Modifications Smoking Dietary Intervention Obesity Diabetes Mellitus Symptomatic Therapy Cardiac Rehabilitation Pharmacologic Therapy β-Blockers Calcium Channel Blockers Nitrates Acute Relief of Angina Prevention of Anginal Episodes Potassium Channel Agonists Miscellaneous Medical Therapies Coronary Revascularization Percutaneous Coronary Intervention Indications: Percutaneous Coronary Intervention Versus Medical Treatment Percutanous Coronary Intervention Versus Coronary Artery Bypass Grafting Culprit Lesion Percutaneous Coronary Intervention Percutaneous Coronary Intervention After Coronary Artery Bypass Grafting Stents Antiplatelet Therapy Complications Coronary Artery Bypass Graft Surgery Indications: Coronary Artery Bypass Grafting Versus Medical Treatment Complications Arterial Conduits Prevention of Coronary Events Cardiac Rehabilitation Antiplatelet Therapy Lipid-Lowering Therapy β-Blockers Angiotensin-Converting Enzyme Inhibition Coronary Revascularization Coronary Artery Bypass Graft Surgery Potential Future Therapies Cholesteryl Ester Transfer Protein Inhibitors Novel Antiplatelet Therapies References Chapter 9: Non–ST-Segment Elevation Acute Coronary Syndromes Antiischemic Medications Nitrates β-Adrenergic Receptor Blockers Calcium Channel Antagonists Ranolazine Antiplatelet Agents Aspirin P2Y12 Antagonists Clopidogrel Prasugrel Ticagrelor Duration of Therapy Platelet Function Testing and Genetics Intravenous Platelet Inhibitors Conclusions Anticoagulants Unfractionated Heparin and Low-Molecular-Weight Heparin Direct Thrombin Inhibitors Factor Xa Inhibitors Other Anticoagulants Summary on Anticoagulant Selection Invasive Versus Conservative Strategy for Cardiac Catheterization Hospital Discharge and Postdischarge Care Antiplatelet Therapy, Anticoagulation, Angiotensin-Converting Enzyme Inhibitors, and Angiotensin Receptor Blockade β-Blockade and Blood Pressure Control Cholesterol Treatment and Cigarette Smoking Cessation Diabetes Management and Diet Exercise Influenza Vaccine Cardiac Syndrome X Cocaine and Methamphetamines Diabetes Mellitus The Elderly Women Chronic Kidney Disease References Chapter 10: ST-Segment Elevation Myocardial Infarction Overview Pre?ST-Segment Elevation Myocardial Infarction Management Prehospital Management Symptom Recognition Out-of-Hospital Arrest Emergency Medical Services and Systems of Care Prehospital Fibrinolysis Prehospital Destination Protocols Emergency Department Management Patient Triage Patient Evaluation Early Risk Assessment Medications Used in the Acute Phase Oxygen Nitroglycerin Analgesia Antiplatelet Agents Aspirin Clopidogrel Prasugrel Ticagrelor Glycoprotein IIb/IIIa Inhibitors Anticoagulant Agents Antithrombins Direct Thrombin Inhibitors Fondaparinux β-Blockers Reperfusion Therapy General Concepts Time from Symptom Onset Risk Stratification in ST-Segment Elevation Myocardial Infarction Risk of Bleeding Predicted Transfer and Door-to-Balloon Time Fibrinolytic Therapy Indications and Contraindications Mortality Benefit Effect on Left Ventricular Function Complications Comparison of Fibrinolytic Agents Percutaneous Coronary Intervention Primary Use of Stents Thrombus Aspiration Pharmacoinvasive Management Hospitals Without on-Site Cardiac Surgery Hospital Management Location Routine Measures Medications Nitroglycerin Antithrombotic Agents β-Blockers Inhibition of the Renin-Angiotensin-Aldosterone System Glycemic Control Calcium Channel Blockers Hemodynamic Disturbances Hemodynamic Assessment Hypotension Low-Output State Pulmonary Congestion Cardiogenic Shock Right Ventricular Infarction Mechanical Complications Mitral Regurgitation Ventricular Septal Rupture Left Ventricular Free Wall Rupture Left Ventricular Aneurysm and Left Ventricular Thrombus Mechanical Support Devices Arrhythmias Bradyarrhythmias Supraventricular Arrhythmia Ventricular Arrhythmias Recurrent Chest Pain Recurrent Ischemia or Infarction Pericarditis Other Complications Ischemic Stroke Deep Venous Thrombosis and Pulmonary Embolism Hemorrhagic Complications Coronary Artery Bypass Surgery Risk Stratification Exercise Testing Echocardiography Myocardial Perfusion Imaging Left Ventricular Function Myocardial Viability Invasive Evaluation Assessment of Electrical Substrate Long-Term Management Risk Factor Control Weight Management Smoking Cessation Lipid Management Blood Pressure Control Diabetes Management Medications Antiplatelet Agents β-Blockers Statins Inhibition of the Renin-Angiotensin-Aldosterone System Warfarin Hormone Replacement Therapy Functional Status Physical Activity Cardiac Rehabilitation Psychosocial Impact Follow-Up Visit Return to Work and Disability References Chapter 11: Advances in Coronary Revascularization Overview Advances in Coronary Stenting Pre-Stent Era Bare-Metal Stents Drug-Eluting Stents Development of Drug-Eluting Stents Drug-Eluting Stents Currently Available in the United States Sirolimus-Eluting Stents Paclitaxel-Eluting Stents Zotarolimus-Eluting Stents and Everolimus-Eluting Stents Efficacy and Safety of Drug-Eluting Stents Efficacy of Drug-Eluting Stents Safety of Drug-Eluting Stents When to Use Drug-Eluting Stents New Drug-Eluting Stents Available Outside the United States or Undergoing Investigation Products Involving Changes to the Stent Platform Traditional Stent Platforms Biodegradable Stents Products Involving Changes to Drug Coatings Products Involving Changes to the Polymer Structure Stents with Durable Polymers Stents with Biodegradable Polymers Biolimus A9?based Stents. Myolimus-Based Stents. Paclitaxel-Based Stents. Everolimus-Based Stents. Sirolimus-Based Stents. Polymer-Free Stents Drug-Coated Balloons Advances in Revascularization in Specific Conditions Saphenous Vein Graft Interventions Chronic Total Occlusion Intervention Bifurcation Lesion Treatment Advances in Catheterization Techniques Transradial Access Mechanical Support for High-Risk Percutaneous Coronary Intervention Intravascular Assessment of Lesion Severity Advances in Surgical Coronary Revascularization Minimally Invasive Surgical Coronary Revascularization Off-Pump Coronary Artery Bypass Grafting Small-Access Coronary Revascularization Minimally Invasive Direct Coronary Artery Bypass Thoracoscopic Minimally Invasive Direct Coronary Bypass Multivessel Minimally Invasive Procedures Robotically Assisted Revascularization Non?Left Internal Mammary Arterial Conduits in Surgical Revascularization Background and Introduction Right Internal Mammary Artery for Use in Bilateral Mammary Artery Grafting Radial Artery Grafts Gastroepiploic Artery Grafts Hybrid Coronary Revascularization Introduction and Definition Rationale and Background Technical and Timing Issues of Hybrid Interventions Percutaneous Intervention Before Surgical Intervention Surgical Intervention Before Percutaneous Intervention Simultaneous Procedures Current State of Hybrid Revascularization and Recent Information Future Directions References Part III: Heart Failure Chapter 12: Pharmacologic Management of Heart Failure in the Ambulatory Setting Pathophysiology and Staging System: Targets of Therapy Diuretics and Sodium Restriction Pathophysiologic Mechanisms Sodium Restriction Diuretics Mechanisms of Action Adverse Effects Practical Considerations Renin-Angiotensin System Inhibitors Pathophysiologic Mechanisms Clinical Efficacy Angiotensin-Converting Enzyme Inhibitors Cooperative North Scandinavian Enalapril Survival Study CONSENSUS Vasodilator Heart Failure Trial V-HeFT II Studies of Left Ventricular Dysfunction SOLVD Assessment of Treatment with Lisinopril and Survival ATLAS Angiotensin Receptor Blockers Practical Considerations Angiotensin-Converting Enzyme Inhibitors Angiotensin Receptor Blockers β-Blockers Pathophysiologic Rationale Pharmacology Clinical Efficacy Cardiac Insufficiency Bisoprolol Studies CIBIS I and II U.S. Carvedilol Heart Failure Trials Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure MERIT-HF β-Blocker Evaluation and Survival Trial Carvedilol Prospective Randomized Cumulative Survival Trial COPERNICUS Carvedilol and Metoprolol European Trial COMET Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction CAPRICORN Study of the Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors with Heart Failure SENIORS Practical Considerations Choice of β-Blocker Aldosterone Antagonists Pathophysiology Clinical Efficacy Practical Considerations Options for Patients who Remain Symptomatic Despite Standard Therapy Hydralazine and Isosorbide Dinitrate Practical Considerations Digoxin Pharmacologic and Clinical Effects Practical Considerations Calcium Channel Blockers Positive Inotropic Agents Oral Positive Inotropes Intravenous Positive Inotropes Bridge to Transplantation Bridge to End of Life Antithrombotic Therapy Antiarrhythmic Therapy Special Considerations Heart Failure Patients with Preserved Ejection Fraction Clinical Efficacy Practical Considerations Patients with Ischemic Heart Disease Patients with Valvular Heart Disease Patients with Diabetes Gender, Race, and Ethnic Considerations Patients with Myocarditis Future Directions in Pharmacologic Therapy Pharmacotherapy Comorbidities References Chapter 13: Implantable Devices for the Management of Heart Failure Implantable Cardioverter-Defibrillators in the Management of Heart Failure MADIT II DEFINITE SCD-HeFT Implantable Cardioverter-Defibrillators Early After Myocardial Infarction DINAMIT IRIS Indications for Prophylactic Cardioverter-Defibrillator Implantation in Heart Failure Patients Practical Considerations in Implantable Cardioverter-Defibrillator Therapy Conduction Abnormalities in Heart Failure Landmark Cardiac Resynchronization Therapy Clinical Trials MUSTIC MIRACLE MIRACLE ICD CONTAK CD COMPANION CARE-HF Cardiac Resynchronization Therapy in Mild Heart Failure REVERSE MADIT-CRT RAFT Cardiac Resynchronization Therapy Cardiac Resynchronization Therapy in Long-Term Right Ventricle Pacing Cardiac Resynchronization Therapy in Atrial Fibrillation Indications for Cardiac Resynchronization Therapy in Heart Failure Patients Future Directions of Cardiac Resynchronization Therapy Monitoring Heart Failure Through Implantable Devices Future Directions in Implantable Devices for the Management of Heart Failure Summary References Chapter 14: Strategies for Management of Acute Decompensated Heart Failure Terminology Epidemiology Pathophysiology Heart Failure with Reduced Versus Preserved Ejection Fraction Acute Compensatory Mechanisms Myocardial Injury Common Precipitating Factors of Heart Failure General Management Initial Patient Evaluation Risk Stratification Clinical Assessment of Intracardiac Filling Pressures Clinical Assessment of Systemic Perfusion Laboratory Assessment B-Type Natriuretic Peptide Noninvasive Versus Invasive Management Hemodynamic Profiles Hemodynamic Goals of Therapy Fluid Management Parenteral Diuretic Therapy Ultrafiltration Vasoactive Therapy Nitroglycerin Nesiritide Nitroprusside Dobutamine Milrinone Dopamine Epinephrine and Norepinephrine Digoxin Adjustment of Oral Medications Renin-Angiotensin-Aldosterone System Inhibitors Nitrates and Hydralazine β-Blockers Oral Diuretics Other Management Issues Sodium and Fluid Restriction Oxygen Supplementation Ventricular Arrhythmias Anticoagulation Comorbidities Discharge Planning and Immediate Postdischarge Care Special Considerations Mechanical Circulatory Support Acute Pulmonary Edema Heart Failure with Preserved Ejection Fraction Unfulfilled Promises and Future Directions References Chapter 15: Cardiac Transplantation and Circulatory Support Devices Overview Patient Selection for Advanced Heart Failure Therapies Cardiac Transplantation Patient Selection Assessment of Cardiac Disease Severity Assessment of the Pulmonary Vasculature Other Cardiac Transplantation Candidacy Issues Age Comorbidities Immunologic Sensitization Listing for Cardiac Transplantation Pretransplantation Patient Management Cardiac Transplantation Surgical Technique Management of the Patient After Cardiac Transplantation Prevention and Treatment of Cardiac Rejection Drug Interactions Prevention and Treatment of Posttransplant Complications Infections Hypertension Diabetes Dyslipidemia Cardiac Allograft Vasculopathy Renal Insufficiency Malignancy Future Directions Mechanical Circulatory Support Benefits of Mechanical Circulatory Support Hemodynamic Biologic Configuration of Mechanical Circulatory Support Pulsatile Flow Continuous Flow Cannulation Indications for Mechanical Circulatory Support Univentricular Versus Biventricular Support Timing of Support Considerations Prior to Long-Term Mechanical Circulatory Support Cardiac Considerations Right Ventricular Function Valvular Disease Arrhythmias Other Cardiac Abnormalities Noncardiac Considerations Surgical Considerations Other Considerations Adverse Events References Chapter 16: Regenerative Therapy for Heart Failure Circulating Progenitor Cells and Myocardial Regeneration Hematopoietic Stem Cell Transdifferentiation Bone Marrow Cells and Clinical Studies Endogenous Cardiac Progenitors Age, Cardiac Disease, and Human Cardiac Stem Cell Function References Chapter 17: Hypertrophic, Restrictive, and Infiltrative Cardiomyopathies Hypertrophic Cardiomyopathy Management of Left Ventricular Outflow Tract Obstruction Therapies for Nonobstructive Hypertrophic Cardiomyopathy Prevention of Sudden Cardiac Death in Hypertrophic Cardiomyopathy Management of Atrial Fibrillation in Hypertrophic Cardiomyopathy Screening at-Risk Family Members for Hypertrophic Cardiomyopathy Restrictive and Infiltrative Cardiomyopathies Idiopathic Restrictive Cardiomyopathy Cardiac Amyloidosis Cardiac Sarcoidosis Treatment Cardiac Hemochromatosis Treatment Storage Diseases of the Myocardium Fabry Disease Cardiomyopathy Associated with Mutations in LAMP2 Danon Disease, PRKAG2, or Mitochondrial Genes Endomyocardial Disorders Endomyocardial Fibrosis Löffler Hypereosinophilic Syndrome References Part IV: Arrhythmias and Conduction Disturbances Chapter 18: Clinical Pharmacology of Antiarrhythmic Drugs Classification of Antiarrhythmic Drugs Drugs Lidocaine Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Mexiletine Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Procainamide Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Disopyramide Clinical Applications Mechanisms of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Quinidine Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Propafenone Clinical Applications Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Drug Interactions Flecainide Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Sotalol Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Amiodarone Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Ibutilide Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Dofetilide Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Drug Reactions Drug Interactions Adenosine Clinical Applications Mechanism of Action Clinical Pharmacology Dosage and Administration Modification of Dosage in Disease States Adverse Reactions Drug Interactions Dronedarone Clinical Applications Mechanism of Action Clinical Pharmacology Individualization of Dosage Modification of Dosage in Disease States Adverse Reactions Drug Interactions Appendix References Chapter 19: Pharmacologic Management of Supraventricular Tachycardias Pharmacology of Supraventricular Tachycardias Evaluation of Therapy Paroxysmal Supraventricular Tachycardia Mechanisms of Paroxysmal Supraventricular Tachycardia Management of Acute Episodes of Paroxysmal Supraventricular Tachycardia Long-Term Therapy of Premature Supraventricular Tachycardia Long-Term Pharmacologic Therapy Atrial Flutter Short-Term Management of Atrial Flutter Long-Term Management of Atrial Flutter Multifocal Atrial Tachycardia Inappropriate Sinus Tachycardia Junctional Ectopic Tachycardia References Chapter 20: Atrial Fibrillation Classification Decision for Rhythm or Rate Control Rate Control Pharmacologic Rate Control in Atrial Fibrillation: Optimal Ventricular Rate Nonpharmacologic Approach to Rate Control Rhythm Control Pharmacologic Cardioversion Electrical Cardioversion Maintenance of Sinus Rhythm Pharmacologic Approaches Choice of Drug Initiation and Monitoring of Antiarrhythmic Drugs Adjunctive Therapy for the Maintenance of Sinus Rhythm Nonpharmacologic Approaches to the Maintenance of Sinus Rhythm Pacing for the Maintenance of Sinus Rhythm Thromboembolic Prophylaxis Pericardioversion Anticoagulation Atrial Fibrillation Following Cardiac Surgery Conclusions References Chapter 21: Nonpharmacologic Treatment of Tachyarrhythmias Catheter Ablation for the Treatment of Tachyarrhythmias Practical Considerations Catheter Ablation by Specific Arrhythmia Syndrome Catheter Ablation for Supraventricular Tachyarrhythmias Accessory Pathway?mediated Tachycardias Atrioventricular Node Reentry Atrial Tachycardia Atrial Flutter Isthmus-Dependent Atrial Flutter Other Atrial Flutters Atrial Fibrillation Atrioventricular Junction Ablation for Ventricular Rate Control Catheter Ablation for Ventricular Tachyarrhythmias Idiopathic Ventricular Tachycardia Ventricular Tachycardia in Patients with Structural Heart Disease Ventricular Fibrillation and Polymorphic Ventricular Tachycardia Summary References Chapter 22: Role of Implantable Cardioverter-Defibrillators in Primary and Secondary Prevention of Sudden Cardiac Death Sudden Cardiac Death Implantable Cardioverter-Defibrillator Systems and Technology Implantable Cardioverter-Defibrillators for Secondary Prevention of Sudden Death Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death Clinical Trials Risk Stratification for Sudden Cardiac Death Eje

Manage cardiovascular problems more effectively with the most comprehensive resource available! A trusted companion to Braunwald's Heart Disease, Cardiovascular Therapeutics, 4th Edition addresses pharmacological, interventional, and surgical management approaches for each type of cardiovascular disease. This practical and clinically focused cardiology reference offers a balanced, complete approach to all of the usual and unusual areas of cardiovascular disease and specific therapies in one concise volume, equipping you to make the best choices for every patient.

• Understand current approaches to treating and managing cardiovascular patients for long-term health, for complex problems, and for unusual cardiac events.
• Benefit from the substantial experience of Elliott M. Antman, MD, Marc S. Sabatine, MD, and a host of other respected authorities, who provide practical, evidence-based rationales for all of today's clinical therapies.
• Expand your knowledge beyond pharmacologic interventions with complete coverage of the most effective interventional and device therapies being used today.
• Easily reference Braunwald's Heart Disease, 9th Edition for further information on topics of interest.

• Make the best use of the latest genetic and molecular therapies as well as advanced therapies for heart failure.
• Cut right to the answers you need with an enhanced focus on clinically relevant information and a decreased emphasis on pathophysiology.
• Stay current with ACC/AHA/ESC guidelines and the best ways to implement them in clinical practice.
• Get an enhanced visual perspective with an all-new, full-color design throughout.
• Access the complete contents online and download images at www.expertconsult.com.