Diagnosis and Treatment of Acute Coronary Syndrome

Presentation Agenda

Antithrombotic Therapy for Medically Managed STEMI: 19 minutes

Christopher P. Cannon, MD (Chair)
Associate Professor of Medicine
Cardiovascular Division, Department of Medicine
Brigham and Women's Hospital
Harvard Medical School
Boston, MA

Christopher P. Cannon, MD, discloses that he receives research grants/support from Accumetrics, AstraZeneca, Bristol-Myers Squibb/Sanofi Partnership, GlaxoSmithKline, Intekrin Therapeutics, Merck, Merk/Schering-Plough Partnership, Novartis, and Takeda; and he is a clinical advisor with equity in Automedics Medical Systems

Antiplatelet Therapy in Clinical Practice: Balancing the Risks and Benefits: 25 minutes

Deepak L. Bhatt, MD, FACC, FSCAI, FAHA Chief of Cardiology
Director, Integrated Interventional Cardiovascular Program
Brigham & Women's Hospital
VA Boston Healthcare System
Boston, MA

Deepak L. Bhatt, MD, FACC, FSCAI, FAHA, discloses that he receives grant/research support from AstraZeneca, Bristol-Myers Squibb, Elsal, Ethicon, Heartscape, sanofi-aventis, and The Medicines Company

How to Apply New Anticoagulant Data to Clinical Practice: 28 minutes

E. Magnus Ohman, MD, FRCPI, FACC
Professor of Medicine
Director, Program for Advanced Coronary Disease
Division of Cardiology
Duke University Medical Center
Durham, NC

E. Magnus Ohman, MD, FRCPI, FACC discloses that he has a research grant or contract with Bristol-Myers Squibb, CV Therapeutics, Inc., Daiichi Sankyo, Datascope, Eli Lilly & Company, sanofi-aventis, Schering-Plough Corporation, and The Medicines Company; he receives salary support from Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly & Company, sanofi-aventis, Schering-Plough Corporation, and The Medicines Company; he is a consultant for Abiomed, CV Therapeutics, Inc., Datascope, Inovise, Liposcience, Northpoint Domain, Pozen, Inc., Response Biomedical, The Medicines Company, and WebMD (theheart.org); and he has equity in Inovise

Maximizing Patient Outcomes and Compliance: Protecting Post-ACS Patients at Risk for Thromboembolic Complications:
18 minutes

Joanne Foody, MD
Associate Professor of Medicine/Cardiology
Director of the Cardiovascular Wellness Center
Brigham and Women's Faulkner Hospitals
Boston, MA

Joanne Foody, MD, discloses that she is a consultant/independent contractor for Merck, sanofi-aventis, Pfizer, and Schering-Plough

Discussion: 7 minutes

Post-test and Evaluation: 5 minutes

Release date: December 31, 2009

Expiration date: December 31, 2010

Estimated time to complete activity: 2.0 hours

Hardware/Software Requirements:

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Statement of Need

In 2008, an estimated 770,000 Americans had a new MI attack and about 430,000 had a recurrent attack. It is estimated that an additional 190,000 silent MIs occur each year. Results compiled by the American Heart Association (AHA) indicate that there were 1,413,000 hospitalizations for acute coronary syndromes (ACS) in 2005, 838,000 for MI, and 558,000 for UA. ACS account for more deaths in the United States than any other disease or form of injury. Results from one recent series of 1,188 patients hospitalized with ACS indicated that in-hospital mortality was 9.6% for STEMI, 13% for NSTEMI, 2.6% for UA. At a median follow-up of 10 months, the respective values were 19%, 27% and 12%.

Management of patients with ACS requires rapid and coordinated intervention at the time of the event as well as careful patient follow-up to minimize the risk for mortality from the index event and to prevent recurrence. Despite extensive evidence supporting aggressive intervention and comprehensive management of patients along a continuum of care that includes acute stabilization and early, in-hospital implementation of secondary preventive measures, treatment of many patients with ACS remains far from optimal. For example, results from a prospective survey of 501 consecutive ACS cases indicated that only 45% of very high-risk patients underwent angiography during their initial hospitalization and that they had longer waiting times for this procedure than low-risk patients. Traditional medication with aspirin and beta-blockers was widely used, but statins, glycoprotein (GP) IIb/IIIa receptor antagonists, and invasive therapy were underutilized in these patients. Similarly, results from the GRACE (Global Registry of Acute Coronary Events) registry that included 95 hospitals and 11,543 patients with ACS indicated significantly variability across sites in the use of percutaneous coronary intervention (PCI), GP IIb/IIIa inhibitors, and statins.

The purpose of this activity is to offer cardiologists and other medical professionals an opportunity to learn of recent advances in the diagnosis and treatment of ACS patients, which will aid them in the implementation of numerous interventions aimed at improving care and outcomes for these patients.

Target Audience

This program is intended for cardiologists and other health care professionals.

Learning Objectives

After completing this self-study module, learners should be able to:

  • Identify signs, symptoms, and prognostic features of ACS
  • Describe the importance of inhibition of platelet aggregation in patients with ACS
  • Explain the recommendations, with the supporting rationale, for use of antiplatelet therapy in ACS management
  • Review the results of pivotal studies involving the use of antiplatelet therapy in patients with ACS
  • Describe the AHA/ACC Guidelines for NSTEMI or UA for the treatment of appropriately risk-stratified patients
  • Restate the efficacy and safety of different antiplatelet agents that may be used in the setting of ACS

This activity was designed to address the following IOM competencies

Improve competence, provide patient-centered care, and employ evidence-based practice.

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Global Education Group (Global) and Carden Jennings Publishing Co., Ltd. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Unapproved Use Disclosure Statement

The information provided in this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient's medical condition.

Off-Label Disclosure Statement

The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

Planner and Faculty Disclosure

The following planning committee members have indicated they have no relationship(s) with industry to disclose relative to the content of this CME activity: Jackie Dawson, MSN, Amanda Glazar, PhD.

Contact Information

Global Education Group

Sponsored by

This activity is jointly sponsored by Global Education Group and Carden Jennings Publishing Co., Ltd.

Supported by

This activity is supported by an educational grant from Daiichi Sankyo, Inc. and Lilly USA, LLC, and the Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership.

Instructions to Receive Credit

To receive credit, participants must review the materials on accreditation information, target audience, learning objectives, and disclosure information; complete the CME Pre-test; Complete (read/view/listen to) the entire self-study activity; complete the self-assessment and evaluation form. To receive credit for this activity, participants must follow the instructions provided on the evaluation form. When completed, they will be able to immediately access and print the certificate for the appropriate credit. There is no fee to participate in the activity or for the generation of the certificate. The activity expires December 31, 2010; no credit will be awarded after this date.

Before viewing the program, download and complete the CME Pre-test at the link below.

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