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Clin. Cardiol. 23, 233 (2000)
Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease
Edited by A. Michael Lincoff and Eric J. Topol
Humana Press, Inc., Totowa, N.J. (1999)
368 pages, illustrated, $125.00
ISBN: 0-896-03727-4
In recent years the role of the platelet in the pathophysiology of ischemic cardiovascular disease has become increasingly evident, and the use of various platelet-inhibiting medications has become widespread. A most exciting development in antiplatelet therapy is the creation of platelet glycoprotein IIb/IIIa receptor inhibitors, which bring a new dimension to the options available for the effective treatment of ischemic cardiovascular disease. Basic scientific and clinical researchers have published and presented a tremendous amount of new information regarding these agents, and pharmaceutical companies have marketed them widely. Information on the new drugs and their use has at times seemed overwhelming and variable. This timely volume sets out to review the information currently available regarding platelet function and pathophysiology, GP IIb/IIIa receptor structure and function, and GP IIb/IIIa receptor inhibitors and their use during coronary intervention and in the treatment of acute ischemic syndromes.
The editors have achieved their goal admirably and maintain clarity and focus by dividing the 368-page volume into four parts. In Part I, four chapters review the thrombotic process involved in acute coronary syndromes, including the roles of platelets (in particular, the GP IIb/IIIa receptor), the atherosclerotic plaque, and the coagulation cascade, with one chapter each devoted to the processes of platelet adhesion and aggregation. Another chapter reviews the development and pharmacology of various GP IIb/IIIa inhibitors. Part II includes five chapters on the use of GP IIb/IIIa inhibitors during coronary intervention, a topic that has seen increasing support as more evidence of efficacy has been established by clinical trials. Two chapters on the use of GP IIb/IIIa receptor inhibitors in the treatment of unstable angina and acute myocardial infarction comprise Part III. Part IV includes chapters on economics, monitoring of platelet aggregation, oral agents, cerebrovascular complications of these antiplatelet agents as well as their potential therapeutic use in treating cerebrovascular disease, and considerations of the future of GP IIb/IIIa receptor inhibitors.
This text is written by multiple scientists and cardiologists extremely experienced in the use of these agents. They present the relevant data concisely, clearly, and objectively, yet offer recommendations based on their analyses and synthesis of the data. The book is well organized, includes useful diagrams and tables, is extensively referenced, comprehensive, and looks to the future. It is useful, relevant, and practical and should prove an invaluable reference for the physician caring for patients with ischemic cardiovascular disease.
Some limitations are, first, that no disclaimers are provided as to whether the authors and editors have ties to the relevant pharmaceutical companies or whether the book received their support; second, although the basic science portion is clearly written, it is a little dry in places; third, there is significant duplication in several places, perhaps to be expected in a multiauthored book.
Karen M. Smith, M.D.
Asst. Professor of Medicine
Jawahar L. Mehta, M.D., Ph.D.
Professor of Medicine and Physiology
Division of Cardiology
University of Florida
Gainesville, Florida