Antithrombotic Drug Therapy in Cardiovascular Disease
Substantial morbidity and mortality remains associated with thrombotic events has stimulated the rapid expansion of the available armamentarium to combat pathologic thrombosis. Pathologic thrombosis plays an essential role in the pathogenesis of acute cor
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Antithrombotic Drug Therapy in Cardiovascular Disease
Edited by
Arman T. Askari, MD
Western Reserve Heart Care, Hudson, OH, USA
A. Michael Lincoff, MD
The Cleveland Clinic Foundation, Cleveland, OH, USA
Editors Arman T. Askari Western Reserve Heart Care Hudson, OH 44236 USA [email protected]
A. Michael Lincoff Department of Cardiovascular Medicine Cleveland Clinic 9500 Euclid Avenue Cleveland, OH 44195 USA [email protected]
ISBN 978-1-60327-234-6 e-ISBN 978-1-60327-235-3 DOI 10.1007/978-1-60327-235-3 Springer Dordrecht Heidelberg London New York Library of Congress Control Number: 2009928625 © Humana Press, a part of Springer Science+Business Media, LLC 2010 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is for-bidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
To my wife Jamie and our children Alexa, Amanda, and Jacob and to my parents Ali and Houri for their continued support and understanding. Arman T. Askari, MD I would like to recognize the support and patience of my wife Debra and our children Gabrielle, Aaron, and Jacob. A. Michael Lincoff, MD
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Preface It is now well established that pathologic thrombosis plays a central role in the pathogenesis of acute coronary syndromes (ACS), ischemic complications of percutaneous coronary intervention (PCI), venous thromboembolic disease, and embolic complications of arrhythmias and various cardiomyopathies. Born out of the understanding of the integral role of thrombus formation across the spectrum of cardiovascular diseases is the burgeoning field of antithrombotic therapies. Rigorous investigation of individual or various combinations of the available antithrombotic regimens including fibrinolytic agents, antiplatelet therapies (aspirin, the thienopyridines, glycoprotein IIb/IIIa inhibitors), and anticoagulant therapies (unfractionated heparin, low-molecular-weight heparins, direct thrombin inhibitors, and synthetic factor X inhibitors) has lead to a marked improvement in outcomes for patients with a thrombotic event. Nevertheless, a substantial morbidity and mortality remains associated with these thrombotic events. This realization has fueled the rapid expansion of the available armamentarium to combat pathologic thrombosis. Antithrombotic
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