Coronary Artery Disease: Therapeutics and Drug Discovery (Advances in Experimental Medicine and Biology, 1177)

Contents
Contributors
1 Coronary Artery Disease: From Mechanism to Clinical Practice
	1.1 Epidemiology
		1.1.1 Prevalence
		1.1.2 Incidence Demographics
		1.1.3 Temporal Trends
		1.1.4 International Trends
		1.1.5 STEMI or Non-STEMI
	1.2 Risk Factors
		1.2.1 Risk Factor Prevalence
		1.2.2 Hypertension
		1.2.3 Lipids and Lipoproteins
		1.2.4 Diabetes Mellitus
		1.2.5 Chronic Kidney Disease
		1.2.6 Age and Genders
		1.2.7 Family History
		1.2.8 Risk Factors in Childhood
		1.2.9 Lifestyle Factors—Cigarette Smoking
		1.2.10 Diet
		1.2.11 Obesity
		1.2.12 Exercise
		1.2.13 Psychosocial Factors
		1.2.14 Inflammatory Markers
	1.3 Clinical Presentation
		1.3.1 Characteristics of Angina
		1.3.2 Grading of Angina Pectoris
		1.3.3 AMI General Appearance
		1.3.4 Right Ventricular Infarction
		1.3.5 Imaging
		1.3.6 Other Imaging Modalities
		1.3.7 Estimation of Infarct Size
		1.3.8 The Presentations of Anginal Pain in NSTE-ACS Patients Are as Follows
		1.3.9 Woman: Clinical Presentation
	1.4 Complications of Acute Myocardial Infarction
		1.4.1 Left Ventricular Dysfunction
		1.4.2 Cardiogenic Shock
		1.4.3 Rupture of the Free Wall
		1.4.4 Rupture of the Interventricular Septum
		1.4.5 Rupture of a Papillary Muscle
		1.4.6 Ventricular Arrhythmias
		1.4.7 Atrial Flutter and Fibrillation
		1.4.8 Other Complications
	1.5 Pathophysiology of Atherosclerosis
		1.5.1 Platelet Activation and Thrombosis
		1.5.2 Endothelial Dysfunction
		1.5.3 Inflammation
		1.5.4 Oxidant Stress
		1.5.5 Smooth Muscle Cell Proliferation
		1.5.6 Genetic Factors
	References
2 Evidence in Guidelines for Treatment of Coronary Artery Disease
	2.1 Part 1: Diet and Lifestyle Management of CAD Risk Factors
		2.1.1 Diet Management of CAD Risk Factors
		2.1.2 Lifestyle Management
		2.1.3 Weight Control
	2.2 Part 2: Evidence in Guidelines for Treatment of ACS
		2.2.1 Guidelines on Treatment of STEMI
		2.2.2 Guidelines on Treatment of NSTE-ACS
	2.3 Part 3: Evidence in Guidelines for Treatment of Chronic Stable CAD
		2.3.1 Pharmacological Management (See Major Recommendations from Different Guidelines in Table 2.1)
		2.3.2 Revascularization
		2.3.3 Medicine of Prognosis Improvement
		2.3.4 Risk Factors Management
	References
3 Revascularization for Coronary Artery Disease: Principle and Challenges
	3.1 Evidence and Recommendations for Revascularization
	3.2 Fibrinolysis
		3.2.1 Indications and Contraindications for Fibrinolytic Therapy
		3.2.2 Fibrinolytic Agents
		3.2.3 Complications
	3.3 Percutaneous Coronary Intervention
		3.3.1 Type of Drug-Eluting Stents
		3.3.2 Indications for Use of Drug-Eluting Stents
		3.3.3 Periprocedural Complications
	3.4 Coronary Artery Bypass Grafting
		3.4.1 The Choice of Conduits
		3.4.2 Periprocedural Complications
	3.5 Decision-Making for Revascularization
		3.5.1 Heart Team
		3.5.2 Left Main Disease
		3.5.3 Multivessel Disease
		3.5.4 CAD with Comorbidities
		3.5.5 Unstable Angina and Non-ST-Segment Elevation Acute Coronary Syndromes
		3.5.6 ST-Segment Elevation Myocardial Infarction
	3.6 Secondary Prevention
		3.6.1 Medical Therapy
		3.6.2 Exercise
	References
4 Antithrombotic Drugs—Pharmacology and Perspectives
	4.1 Hemostasis and Thrombosis
		4.1.1 Platelet
		4.1.2 Coagulation
		4.1.3 Fibrinolysis and Thrombolysis
		4.1.4 Arterial Thrombosis
		4.1.5 Venous Thrombosis
	4.2 Principles of Antithrombotic Therapy
		4.2.1 Antiplatelet Therapy
		4.2.2 Anticoagulant Therapy
		4.2.3 Thrombolytic Therapy
	4.3 Antiplatelet Drugs and Limitations
		4.3.1 Aspirin
		4.3.2 ADP Receptor Antagonists
		4.3.3 GPIIBIIIa Inhibitors
		4.3.4 Cilostazol
		4.3.5 Vorapaxar
	4.4 Anticoagulants and Limitations
		4.4.1 Parenteral Anticoagulants
		4.4.2 Oral Anticoagulants
	4.5 Thrombolytic Drugs and Limitations
		4.5.1 Streptokinase
		4.5.2 Urokinase
		4.5.3 Tissue Plasminogen Activator, t-PA
		4.5.4 Anistreplase
		4.5.5 Tenecteplase
		4.5.6 Reteplase
	4.6 Challenges and Perspectives
		4.6.1 Antiplatelet Drugs
		4.6.2 Anticoagulants
		4.6.3 Thrombolytic Drugs
	References
5 Lipid-Modifying Drugs: Pharmacology and Perspectives
	5.1 Lipids Metabolism (Cholesterol Metabolism, TG Metabolism)
		5.1.1 Cholesterol Metabolism
		5.1.2 TG Metabolism
	5.2 LDL, HDL, Triglyceride, and Cardiovascular Risk
	5.3 Principles of Lipids Modifying Therapy
	5.4 Lipid-Lowering Drugs and Limitations
		5.4.1 Statins
		5.4.2 Cholesterol Absorption Inhibitor
		5.4.3 PCSK9 Inhibitor
		5.4.4 Niacin
		5.4.5 PPAR Agonist
		5.4.6 PUFA
		5.4.7 Combination Therapy
	5.5 Challenges and Perspectives
	References
6 Hypertension Drug Therapy
	6.1 Hypertension Ascertainment
	6.2 Hypertension-Modified Organ Damage (Williams et al. 2018; Corretti et al. 2002; Messerli et al. 2007)
		6.2.1 Subclinical Organ Damage
		6.2.2 Established Cardiovascular or Renal Diseases
		6.2.3 Other Risk Factors
	6.3 Intervening Risk Factors of Atherosclerotic Cardiovascular Disease (ASCVD) Concomitantly
	6.4 Assessment of Cardiovascular Risk
		6.4.1 Cardiovascular Risk Assessment
		6.4.2 Calculating Cardiovascular Age
		6.4.3 The Presence of Concomitant Disease
		6.4.4 Treated BP Value
	6.5 Antihypertensive Agents
		6.5.1 Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors) (Arnett et al. 2019; Messerli et al. 2018)
		6.5.2 Angiotensin II Receptor Blockers (ARBs)
		6.5.3 Direct Renin Inhibitor
		6.5.4 Thiazide-Type Diuretics
		6.5.5 Thiazide-like Diuretics Include Indapamide, Metolazone, and Chlorthalidone
		6.5.6 Loop Diuretics: Bumetanide, Furosemide, Torsemide, and Ethacrynic Acid
		6.5.7 Potassium-Sparing Diuretics
		6.5.8 Summary: Diuretics in the Treatment of Hypertension
		6.5.9 Calcium Channel Blockers (CCBs)
		6.5.10 Adrenergic Receptor Blockers
		6.5.11 Aldosterone Antagonists (Also See Sect. 6.5.7 Potassium-Sparing Diuretics)
		6.5.12 Direct-Acting Vasodilators
		6.5.13 Epithelial Sodium Channel (ENaC) Inhibitors
		6.5.14 Alpha-2 Agonists, Central-Acting
		6.5.15 Peripherally Acting Adrenergic Agents
		6.5.16 Endothelin Receptor Blockers
	6.6 Hypertension Treatment
		6.6.1 Purpose of Antihypertensive Therapy
		6.6.2 Drug Therapy Indications
		6.6.3 Benefit from Lowering BP
		6.6.4 Goal of BP
		6.6.5 The Rapidity of the Antihypertensive Treatment
		6.6.6 Strategy of Antihypertensive Therapy
		6.6.7 Lifestyle Intervention of Hypertension
		6.6.8 Selection of Antihypertensive Drugs for Initiation Therapy Based on
		6.6.9 Management of Isolated Systolic High BP
		6.6.10 Sexual Dysfunction
		6.6.11 Antihypertensive Agent-Related Cough
		6.6.12 Withdrawal Syndrome
		6.6.13 Caution in Determining RAAS
	6.7 Hypertensive Emergencies and Urgency
	6.8 Hypertensive Urgencies
	6.9 Specific Hypertensive Emergencies
		6.9.1 Hypertensive Encephalopathy
		6.9.2 Hypertensive Left Ventricular Failure
		6.9.3 Acute Aortic Dissection
		6.9.4 Preeclampsia
	6.10 Patients with Diabetes and Hypertension
	6.11 Metabolic Syndrome
	6.12 Antihypertensive Treatment in Patients with Acute Ischemic Stroke
	6.13 Antihypertensive Management of Acute Intracerebral Hemorrhage
	6.14 Secondary Prevention of Stroke (Toschke et al. 2011; Lakhan and Sapko 2009; Progress Collaborative Group 2001; Liu et al. 2009)
	6.15 Hemodialysis Patients with Hypertension
	6.16 Treatment of Hypertension After Renal Transplantation
	6.17 Antihypertensive Therapy of Hypertension in Patients with Chronic Kidney Disease
	6.18 Hypertensive Disorders in Pregnancy (Gestational Hypertension)
		6.18.1 Classifications of Pregnant-Related hypertension (Chobanian et al. 2003)
		6.18.2 Female Hypertension Patients Are Planning Pregnancy
		6.18.3 Pregnant-Related Hypertension
		6.18.4 Therapeutic Indications
		6.18.5 Treatment of Pregnancy-Related Severe Hypertension
		6.18.6 BP Goals
		6.18.7 The Choice of Antihypertensive Agents
		6.18.8 Contraindications
		6.18.9 The Principal in Management of Pregnant-Related Hypertension
		6.18.10 Preeclampsia
		6.18.11 Hypertension Arising During Pregnancy or in the Puerperium
		6.18.12 Postnatal Hypertension
	6.19 Resistant Hypertension
	6.20 Refractory Hypertension
	6.21 Secondary Hypertension
		6.21.1 Renovascular Hypertension
		6.21.2 Screen and Treatment of Other Secondary Hypertensions
	References
7 Pharmaceutical Treatment for Heart Failure
	7.1 Definition and Epidemiology
	7.2 Evaluation of a Patient with Heart Failure
		7.2.1 Recognizing Heart Failure Symptoms
		7.2.2 Identify the Etiologies of HF
		7.2.3 Assessment of the Exacerbating Factors Responsible for Worsening HF
	7.3 Pharmaceutical Management for Heart Failure
		7.3.1 Management of Acute Heart Failure
		7.3.2 Prevention of Disease Progression
		7.3.3 Heart Failure with Preserved EF
	References
8 Drug Discovery for Coronary Artery Disease
	8.1 Lipids Modulating Drugs
		8.1.1 Proprotein convertase subtilisin/kexin type 9 inhibition
		8.1.2 Cholesterol absorption
		8.1.3 Cholesteryl ester transfer protein inhibition
		8.1.4 Targeting high-density lipoprotein cholesterol
		8.1.5 Triglyceride lowering drugs
		8.1.6 Other lipid modulators
	8.2 Targeting Inflammation
	8.3 Antiplatelet Drugs
	8.4 Anticoagulation Drugs
	8.5 Antidiabetic Agents
	8.6 Emerging Therapeutic Targets from GWAS
	8.7 Traditional Chinese Medicine
	8.8 Cardiac Regeneration
	8.9 Cardiovascular Drugs Under Clinical Development
	8.10 Conclusions and Perspectives
	References