Non-communicable diseases account for more than 60% of deaths
globally and continue to grow. Nearly 50% of the 35 million annual
deaths attributable to non-communicable diseases are due to
cardiovascular disease. Acute coronary syndromes (ACS) constitute a
major part of cardiovascular disease. An increase in the prevalence of
major risk factors such as obesity, diabetes and advanced age make the
treatment of cardiovascular disease an urgent issue.
In recent years, significant improvements have been made in our
understanding of the pathophysiology of ACS. Potent pharmacological
agents and innovative invasive treatment strategies have been
developed, and awareness of secondary treatment strategies has
increased. These factors have led to a higher percentage of treatment
and drug adherence and improved short-term clinical outcomes after
ACS. Improved reperfusion strategy and innovative pharmacological
therapies have steadily reduced mortality, but ACS is still a major
cause for acute hospitalizations, and the long-term event rate remains
high, particularly in patients with non-ST-segment elevation
myocardial infarction (NSTEMI).
Despite these recent improvements, cardiovascular disease is
estimated to become the leading cause of death and disability
worldwide by the year 2020.
The atherosclerotic process can be attenuated effectively and its
consequences markedly reduced with proper preventive measures.
With this in mind, many countries where cardiovascular disease is on
the rise have instituted counseling and educational methods to
encourage people to reduce their risks for developing heart disease.
Meanwhile, continued efforts in primary and secondary prevention
measures and better understanding and education of cardiovascular
risk factors are critical to improve cardiac health. List of abbreviations 4
Pathophysiology 7
Diagnosis, risk stratification and decision-making 20
Coronary revascularization 45
Unstable angina/non ST-segment elevation
myocardial infarction 50
ST-segment elevation myocardial infarction 81
Secondary prevention of coronary artery disease 101
Developments 107
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