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Improving Post-PCI Outcomes: Part 3 of 4

Interpreting Current Treatment Guidelines for Optimal Management of the Post-ACS Patient

Activity Expiration

Please note: This activity has expired.

Technical Requirements:
A broadband internet connection
Operating system: Microsoft Windows 98 or later; Mac OS X
Web browser: Microsoft Internet Explorer 6.0 or later; Mozilla Firefox 1.5 or later; Apple Safari
Adobe Flash Player 9.0 or later
(Available at: Get.adobe.com/flashplayer/)

This is a 4-Part Series:
Click here for Part 1.
Click here for Part 2.
Click here for Part 4.

Statement of Need:
Evidence suggests that the greatest barrier to long-term risk-reduction following an acute coronary event is patient adherence. Data from the American Heart Association suggests that 18% of men and 23% of women over the age of 40 will die within 1 year of an initial myocardial infarction. Meanwhile, approximately 20% of acute coronary syndrome (ACS) patients are rehospitalized within 1 year. However, the evidence-based therapeutic management of ACS remains suboptimal.

Target Audience:
This activity has been designed to meet the educational needs of physicians and other clinicians who treat and manage patients following an acute coronary event.

Learning Objective:
Interpret current treatment guidelines and recommendations that support dual antiplatelet therapy following percutaneous coronary intervention, so that patient-centered, individualized care can be provided

Faculty:
Jason Cross, PharmD, RPh
Assistant Professor of Pharmacy Practice
Massachusetts College of Pharmacy and Health Sciences
Worcester, Massachusetts

CME Reviewer:
Gordon F. West, PhD
Annenberg Center for Health Sciences at Eisenhower
Rancho Mirage, CA

This activity will address professional practice gaps in knowledge and competence.

Accreditation and Credit Designation 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 the Annenberg Center for Health Sciences at Eisenhower and Independent Medical Education, LLC (IME). The Annenberg Center is accredited by the ACCME to provide continuing medical education for physicians.

The Annenberg Center designates this educational activity for a maximum of .25 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

There is no charge for this activity. Statements of Credit may be printed online upon successful completion of the posttest or will be mailed 4-6 weeks following activity participation, upon completion and return of the evaluation form to the Annenberg Center for Health Sciences (#4675-3), 39000 Bob Hope Drive, Rancho Mirage, CA 92270 or by fax to 760-773-4550.

Faculty Disclosures:
It is the policy of the Annenberg Center to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty and planners participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationship with those supporting the activity or any others whose products or services are discussed.

In accordance with the Accreditation Council for Continuing Medical Education Standards, parallel documents from other accrediting bodies, and Annenberg Center policy, the following disclosures have been made:

The following faculty has no significant relationship to disclose:
Jason Cross, PharmD, RPh

Additional Content Planners:
The planning committee members, Nimish Mehta, PhD, MBA, and Greselda Butler, have no financial relationships to disclose.

All staff at the Annenberg Center for Health Sciences at Eisenhower have nothing to disclose.

The faculty for this activity has disclosed that there will be discussion about the use of products for non-FDA approved indications.

The ideas and opinions presented in this educational activity are those of the faculty and do not necessarily reflect the views of the Annenberg Center and/or its agents. As in all educational activities, we encourage practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient’s unique clinical situation. The Annenberg Center disclaims all liability and cannot be held responsible for any problems that may arise from participating in this activity or following treatment recommendations presented.

This activity is supported by an independent educational grant from Daiichi-Sankyo, Inc. and Eli Lilly and Company. This activity is an enduring material and consists of audio and video. Successful completion is achieved by viewing the material(s), reflecting on its implications in your practice, and completing the assessment component.

The estimated time to complete the activity is .25 hour(s) or 15 minutes.

This activity was originally released in February 2009 and is eligible for credit through February 28, 2010.

Bibliography:
1. Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol. 2007;50:e1-e157.
2. Antman EM, Hand M, Armstrong PW, et al. 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee. Circulation. 2008;117:296-329.
3. Grines CL, Bonow RO, Casey DE Jr, et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. Circulation. 2007;115:813-818.
4. King SB 3rd, Smith SC Jr, Hirshfeld JW Jr, et al. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, Writing on Behalf of the 2005 Writing Committee. Circulation. 2008;117:261-295.
5. Menzin J, Wygant G, Hauch O, Jackel J, Friedman M. One-year costs of ischemic heart disease among patients with acute coronary syndromes: findings from a multi-employer claims database. Curr Med Res Opin. 2008;24:461-468.
6. O’Donoghue M, Boden WE, Braunwald E, et al. Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis. JAMA. 2008;300:71-80.
7. Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics–2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008;117:e25-e146.
8. Smith SC, Feldman TE, Hirshfeld JW Jr, et al. ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention-Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). J Am Coll Cardiol. 2006;47:216-235.
9. Spertus JA, Kettelkamp R, Vance C, et al. Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry. Circulation. 2006;113:2803-2809.
10. Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007;357:2001–2015.