Acute coronary syndromes affect millions of individuals annually by ca- ing considerable morbidity and mortality. In developed countries this d- ease remains the number one killer, despite significant improvements in its management over the last several decades. Acute coronary syndromes are challenging, as the field is a fast moving one with a rapid proliferation of drug and device trials. These new studies become incorporated into se- rate guideline recommendations by both American and European writing committees, which are frequently updated. Moreover, there are separate guideline recommendations for stable angina, non-ST-elevation acute coronary syndrome, ST-elevation myocardial infarction, and percutaneous coronary intervention. This may make it relatively difficult for practiti- ers to keep up-to-date with the field. Unfortunately, there is often a gap between the guideline recommendations and the care that is delivered in the real world. In this book we have attempted to distil the considerable literature on this topic into an accurate, succinct and up-to-date review of acute coronary s- dromes. Many specialties are involved in the diagnosis and management of these syndromes; therefore, our audience includes a variety of practitioners: cardiologists, general practitioners, emergency medicine physicians, nurses, nurse practitioners, nursing students, physician trainees, medical students, pharmacists, and paramedics. We take the reader through the epidemi- ogy and prognosis, diagnosis and clinical manifestations, risk stratification, and percutaneous and medical therapies across the entire spectrum of acute coronary syndromes. We end with a discussion on current controversies and future approaches to the treatment of acute coronary syndromes.

1 Preface.- 2 Epidemiology US, European, and global perspectives; unstable angina, NSTEMI, STEMI.- 3 Diagnosis symptoms, biomarkers, ECG.- 4 Risk stratification TIMI risk score, GRACE risk score, CRUSADE/PURSUIT risk score.- 5 Medical therapy antithrombotics, statins, etc.- 6 Percutaneous therapy culprit vessel versus mulitvessel; BMS vs DES.- 7 Surgical therapy.- 8 Prognosis. - 9 Controversies optimal antithrombotic strategy, fibrinolysis versus primary PCI for STEMI, preferred mode of revascularization (bare metal stents versus drug eluting stents versus CABG). - 10 Future approaches CT angio and other evolving imaging modalities, biomarkers, proteomics, genomics, angiogenesis, myogenesis. Appendix A Practice Guidelines ACC/AHA and ESC.- Appendix B Synopsis of Key Trials.