Acute coronary syndromes: pathology, diagnosis, genetics, prevention, and treatment.

An acute coronary syndrome (ACS) is the most ominous manifestation of coronary artery disease (CAD). The burden of ACS and its impact are striking. Cardiovascular disease is now the most common cause of mortality worldwide, and among cardiovascular deaths, the majority are attributable to CAD.1 As a result, although CAD in general is a major global public health concern, ACS is particularly worrisome because it is both prevalent but at the same time portends a poor prognosis. Although advanced therapies may alleviate ACS-related morbidity and mortality in well-served communities located in affluent countries, many persons in less-fortunate situations living in low- and middle-income countries remain exposed to the ravages of this disease. Despite this outlook, rapid progress is being made in understanding the pathology, in prevention, and in treatment of ACS. As readers will find even by perusing the headings of the articles in this ACS Compendium, there is much to be optimistic about. As Editors of this ACS Compendium, we are privileged to have played a small role in helping to provide the framework for the esteemed authorship groups to leverage their collective expertise and provide for us a definitive overall review of ACS. In working with these world-renown scientists and clinicians on this collection of ACS articles, which also included a cadre of expert reviewers (to who we are especially thankful), we found ourselves in the enviable position of being privy to a deeply insightful, cutting-edge, and forward-looking appraisal of the current state-of-the-science for ACS. Although this fund of knowledge is clearly set out in the articles that follow, several unexpected points arose from these interactions. The most obvious, somewhat surprisingly, was the question of what exactly is an ACS? The term ACS appeared relatively recently in the medical lexicon. A simple search in PubMed reveals that …