Weighing the Net Clinical Benefit of Oral Antiplatelet Agents: A Clinical Case Discussion and Current Guidelines

Title:	Weighing the Net Clinical Benefit of Oral Antiplatelet Agents: A Clinical Case Discussion and Current Guidelines
Topic:	Cardiology
Relevant Terms:	Acute Coronary Syndrome, Antiplatelet Therapies
Primary Audience:	Cardiologists, Interventional Cardiologists and other healthcare professionals who are interested in the management of patients with ACS.
Launch Date:	22-Mar-12
Credits:	0.25 AMA PRA Category 1 Credit™
Expiration Date:	The accreditation for this activity has expired.
Curriculum Name:	Hot Topics in the Management of Patients with Acute Coronary Syndromes: A Clinical Case...

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Learning Objectives

After completing this activity, the participant will demonstrate the ability to:

Individualize antiplatelet therapy in managing patients with ACS by carefully weighing the net clinical benefit

Faculty

Christopher P. Cannon, MD
Senior Investigator, TIMI Study Group
Cardiovascular Division, Brigham and Women's Hospital
Professor of Medicine, Harvard Medical School
Boston, Massachusetts

Deepak L. Bhatt, MD, MPH
Chief of Cardiology, VA Boston Healthcare System
Director, Integrated Interventional Cardiovascular Program
Brigham and Women's Hospital and VA Boston Healthcare System
Senior Investigator, TIMI Study Group
Associate Professor of Medicine, Harvard Medical School
Boston, Massachusetts

Deepak L. Bhatt, MD, MPH

Dr. Deepak L. Bhatt is Chief of Cardiology at VA Boston Healthcare System and Director of the Integrated Interventional Cardiovascular Program at Brigham and Women's Hospital and VA Boston Healthcare System. He is also a Senior Investigator in the TIMI Study Group and an Associate Professor of Medicine at Harvard Medical School.

After graduating as valedictorian from the Boston Latin School, Dr. Bhatt obtained his undergraduate science degree as a National Merit Scholar at the Massachusetts Institute of Technology, while also serving as a research associate at Harvard Medical School. He received his medical doctorate from Cornell University. He completed his MPH with a concentration in clinical effectiveness at Harvard University. His internship and residency in internal medicine were performed at the Hospital of the University of Pennsylvania, and his cardiovascular training was completed at Cleveland Clinic. He also completed fellowships in interventional cardiology and cerebral and peripheral vascular intervention, as well as serving as Chief Interventional Fellow, at Cleveland Clinic where he went on to spend several years as an interventional cardiologist and an Associate Professor of Medicine. He served for many years as the Director of the Interventional Cardiology Fellowship and as Associate Director of the Cardiovascular Medicine Fellowship. He also served as the Associate Director of the Cleveland Clinic Cardiovascular Coordinating Center. Dr. Bhatt was listed in Best Doctors in America from 2005 through 2012.

Dr. Bhatt's research interests include preventive cardiology, as well as the optimal management of patients with acute coronary syndromes. He also has research interests in advanced techniques in cardiac, cerebral, and peripheral intervention. He has authored or co-authored over 500 publications. He is on several editorial boards. He is the editor of Essential Concepts in Cardiovascular Intervention and Guide to Peripheral and Cerebrovascular Intervention, as well as co-editor of the Handbook of Acute Coronary Syndromes. He was the international principal investigator for the CHARISMA and CRESCENDO trials and co-principal investigator of the CHAMPION and COGENT trials. He serves as the co-chair of the REACH registry. He is also on the steering committees of several trials. He is the current Chair of the American Heart Association-Get with the Guidelines Science Subcommittee. He is the Associate Editor for clinical trials for the American College of Cardiology's Cardiosource. Dr. Bhatt has been a visiting lecturer at a number of prestigious institutions throughout the world. He has been interviewed extensively by news agencies on topics ranging from premature coronary artery disease to the role of inflammation and genetics in heart attacks.

Estimated time to complete activity: 15 minutes

Program Overview

Antiplatelet therapies are the cornerstone of treatment for patients with acute coronary syndrome (ACS) or those undergoing percutaneous coronary intervention (PCI). However, despite many advances and complex treatment regimens, patients with ACS continue to be at significant risk of morbidity and mortality, indicating the need for improved performance on the use of antiplatelet therapy. Some of the hot topics in this field include optimal dosing and duration for antiplatelet regimens, response variability, potential drug-drug interactions, and poor adherence to guideline-recommended therapy. There is an urgent educational need to keep healthcare professionals updated with the current guideline recommendations and also to elucidate how new and emerging data can be incorporated into clinical practice.

A clinical case-based discussion will be used to highlight current guideline recommendations on the use of antiplatelet therapies; current clinical trial data on newer antiplatelet therapies; and strategies for choosing optimal therapy based on patient characteristics. The second case will highlight the role of genetic testing, platelet function testing, and potential drug-drug interactions on the choice of antiplatelet therapy.

Target Audience

This activity is designed for cardiologists, interventional cardiologists and other healthcare professionals who are interested in the management of patients with ACS.

Physician Continuing Medical Education

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 the Postgraduate Institute for Medicine (PIM) and ACCELMED. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

The Postgraduate Institute for Medicine designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The program will be designed as 2 activities (0.25 credits for each 15 minute case). Participants may receive credit for each case.

Disclosure of Conflicts of Interest

The Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Dr. Cannon serves on the advisory board (funds donated to charity) for: Bristol-Myers Squibb/sanofi-aventis Partnership; Novartis International AG; Alnylam Pharmaceuticals, Inc. He is a clinical advisor and holds equity in Automedics Medical Systems. He conducts contracted research for: Accumetrics, Inc.; AstraZeneca; GlaxoSmithKline; Essentialis, Inc.; Merck & Co., Inc.; Takeda Pharmaceuticals North America, Inc. He develops independent educational symposia for: Pfizer, Inc.; AstraZeneca.

Dr. Bhatt conducts contracted research for: Amarin Pharma Inc.; AstraZeneca; Bristol-Myers Squibb; Eisai Inc.; Ethicon, Inc.; Medtronic; sanofi-aventis; The Medicines Company.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

The following PIM planners and managers, Jan Hixon, RN, BSN, MA, Trace Hutchison, PharmD, Julia Kimball, RN, BSN, Samantha Mattiucci, PharmD, Jan Schultz, RN, MSN, CCMEP, and Patricia Staples, MSN, NP-C, CCRN hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

The following ACCELMED planners and managers Jason LeDune and Jason Xu, hereby state no relationships with commercial interests; and Janardhan Sampath, PhD is married to an employee of Bristol-Myers Squibb.

Request for Credit

PIM supports Green CME by offering your Request for Credit online. If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation following the activity. Upon registering and successfully completing the post-test with a score of 70% or better and the activity evaluation, your certificate will be made available immediately. Processing credit requests online will reduce the amount of paper used by nearly 100,000 sheets per year.

Media

Internet

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The Postgraduate Institute for Medicine (PIM), ACCELMED and RealCME do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, ACCELMED, and RealCME. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

PIM Web site: www.pimed.com

Acknowledgement

This activity is supported by an educational grant from Daiichi Sankyo, Inc. and Lilly USA, LLC

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