Evidence-Based Cardiology [antikvár]

Preface In the field of cardiology, pharmacologic agents and procedures increasingly undergo extensive evaluation in large clinical trials. The first goal of this handbook, Evidence-Based Cardiology, is to summarize the data from many of these studies. The results of major randomized trials in six major topic areas are presented in a systematic fashion, including the design, study population, exclusion criteria, treatment regimen, and results. Meta-analyses, review articles, and nonrandomized and less important trials have more abbreviated summaries. The second goal of this handbook is to place all of these annotated references into context, so that the book is not just a compendium of trials. Each chapter begins with an overview that includes a discussion of the importance and relevance of most of these studies. Chapter 1 emphasizes lipid management, as numerous large, randomized trials have been conducted in this area. Other sections review established cardiac risk factors and emerging, potential risk factors. Chapter 2 focuses on the three best studied revascularization procedures: balloon angioplasty, stenting, and bypass surgery. Chapters 3 and 4 cover the wealth of trial information on imstable angina and myocardial infarction. Chapter 5 focuses on the pharmacologic management of heart failure, including the numerous recent trials supporting the use of beta-blockers. The subject of the final chapter is ventricular arrhythmias and atrial fibrillation. Space constraints did not permit us to fully discuss other arrhythmias and antiarrhythmic devices, such as defibrillators or pacemakers; however, we have included a brief overview of several major trials in the treatment of ventricular arrhythmias. We plan to expand this section in the next edition of Evidence-Based Cardiology. The earliest version of this handbook was an extensive bibliography compiled by Peter Sharis during his internal medicine residency. The bibliography gradually progressed to a compendium of annotated references. When several residents, fellows, and cardiologists recommended the work be published, a nearly two-year-long effort ensued to produce a compact, up-to-date handbook that is targeted to general cardiolopsts, medical students, residents, internists, and others with an interest in cardiology and a desire to keep current with the vast amount of evidence-based literature. We acknowledge several cardiologists who provided extremely helpful comments and suggestions on specific chapters: Jorge Plutzky (Chapter 1), Campbell Rogers (Chapter 2), James DeLe-mos (Chapters 3 and 4), Elliott Antman (Chapter 4), and James Fang (Chapter 5). We also thank Eugene Braunwald, whose expert leadership of the Thrombolysis in Myocardial Infarction (TIMI) Study Group has provided us with a greater appreciation and understanding of the importance of well-designed clinical trials, and the careful, considerate analysis and interpretation needed to appropriately incorporate their results into current practice. Peter J. Sharis, M.D. Christopher P. Cannon, M.D. r. j -r t;, I T > mm ¦. • . I. i¦ '¦».¦ ri 'I il