Edited by Ricardo J. Esper and Jorge O. Vilariño. Barcelona: Prous Science, 2002; 234 pages, 53figures, and 36 tables. ISBN 84-8124-196-2.
Ischemic heart disease is the most important cardiological epidemic of modern times. Among the problems related to this condition, the mechanisms that trigger the onset of acute coronary syndrome are of special relevance. Until recently, ischemic heart disease was considered to be related to the degree of arterial occlusion. However, it is now known that plaques with higher cholesterol content and thiner fibrous walls are more prone to rupture, and consequently to acute thrombotic occlusion of the coronary vessel. As a result, cardiologists speak of "stable" plaques with low cholesterol content, thick fibrous walls, and generally significant stenosis versus "unstable," "vulnerable", or "high-risk" plaques where the stenosis may not be critical, but the danger of rupture leading to acute coronary syndrome is greater. Identification of the mechanisms that cause plaques to be "vulnerable" or "high-risk," diagnosis of these plaques (preferably in a non-invasive manner) and determination of their relationship with the various risk factors are an intellectual challenge, as well as a clinical necessity.
Dr. Ricardo J. Esper, and Dr. Jorge O. Vilariño have brought together a group of experts, most of them pioneers in the field, to produce 12 chapters in more than 200 pages that discuss key aspects of "the high-risk arteriosclerotic plaque," the title of the book. The choice of subtitle is also very appropriate, as the book discusses all the aspects related to high-risk plaques "from endothelial dysfunction to acute coronary syndrome." As stated in the prologue, this book has been written by several teams, which gives the reader a window into the opinion of various schools of thought on this specific subject.
The volume contains numerous tables and figures for easier comprehension. Moreover, the short chapters facilitate reading on specific topics. We would like to praise the editors for their excellent work and personal contributions to the book. We sincerely believe the authors have done a great service to spanish-speaking cardiologists by providing them with information on a current topic in such a brilliant manner. Naturally, the joint efforts of both the argentinean cardiologists who participated in this endeavor and of prestigious international teams such as those directed by V. Fuster in New York, J. C. Kaski in London, and G. Lamas in Miami have been extremely important in the final success of this publication, but the directors certainly deserve a great deal of credit for their insight in choosing these authors and gaining their participation in the project.
Lastly, we applaud this magnificent edition produced by Prous Science, an effort in keeping with its other publications.