Understanding the Evidence: The Role of Medication Management and Coronary Intervention in UA/NSTEMI

On-Demand Audio Webcast

ACCME accredited by the University of Kentucky College of Medicine

ACPE accredited by Princeton CME and produced by North American Center for Continuing Medical Education, LLC

Presenter

C. Michael Gibson, MD
Chief of Clinical Research
Division of Cardiology
Beth Israel Deaconess Medical Center
Associate Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Statement of Need

Over 75 million US adults have cardiovascular disease (CVD), the leading cause of death in the United States. Of those individuals with CVD, approximately 17 million have coronary artery disease (CAD), leading to more than 500,000 deaths annually. According to the American Heart Association (AHA), CAD accounts for the largest portion of the annual CVD-related US healthcare burden and ACS—a type of CAD including unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI) and ST-segment elevation myocardial infarction (STEMI)—account for more than 1.5 million US hospitalizations each year. ACS, which result from thrombus formation in the coronary artery, generally require medication management and/or coronary intervention to restore circulation and prevent ischemic complications and mortality. American College of Cardiology (ACC) and AHA clinical practice guidelines incorporate medication management with fibrinolytic therapies, oral and IV antiplatelet options, and antithrombin agents into patient care for US/NSTEMI and STEMI, with or without coronary intervention. Despite the long-standing availability of practice guidelines and a growing armamentarium of treatment options, ACS mortality remains high—approximately 25% of men and 40% of women die in the year following an initial myocardial infarction. Data suggest an inverse correlation between guideline adherence and patient outcomes, including an estimated 10% decrease in mortality risk per 10% increase in guideline adherence. The ongoing burden of ACS and the availability of updated practice guidelines necessitate that hospital-based and managed markets physicians and pharmacists receive education providing practical strategies to incorporate guidelines for improved patient outcomes.

Target Audience

This activity is designed for cardiologists, interventional cardiologists, emergency medicine physicians, hospital pharmacists, and managed markets professionals.

Learning Objectives

After completing this activity, participants should be able to:

Identify the US clinical and economic burden of unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI)
Describe current evidence-based approaches, including medication management and coronary intervention, for the management of UA/NSTEMI
Review the current American College of Cardiology (ACC)/American Heart Association (AHA) practice guidelines for UA/NSTEMI and percutaneous coronary intervention (PCI)
Optimize patient outcomes in UA/NSTEMI by closing the gap between evidence-based guidelines and real-world practice

Activity Overview

This on-demand audio webcast is available with synchronized slides and audio.

To be eligible for documentation of credit, participants must participate in the full educational activity, complete the 10-question post-test with a score of 70% or better, and complete the evaluation form. Participants who successfully complete the post-test and evaluation form online may immediately print their documentation of credit.

Participants who have successfully completed the live version of this activity are not eligible to receive credit for this enduring material.

There is no fee associated with this activity.

Release date: December 17, 2008

Expiration date: June 2, 2009

Estimated time to complete: 1 hour

For questions regarding this educational activity, please contact Angela Scarnici at 609-371-1137.

Hardware/Software Requirements

All educational activities are accessible via a computer with 650 MHz PC, 128 MB RAM, Windows or MAC operating system, Internet Explorer, Netscape or Safari browsers. Windows Media Player, sound card, and speakers are required for streamed audio. Flash Player, sound card, and speakers are required for video programs. A PDF reader is required for print publications. Please direct technical questions to webmaster@naccme.com.

CME Accreditation

The University of Kentucky College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

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

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

The University of Kentucky is an equal opportunity university.

University of Kentucky College of Medicine Test Code: XEN09169.

ACEP Accreditation

Approved by the American College of Emergency Physicians for a maximum of 1 hour(s) of ACEP Category I credit.

CPE Accreditation

Princeton CME is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education (ACPE Provider #452) and complies with the Criteria for Quality and Interpretive Guidelines. This activity is approved for 1 contact hour (0.1 CEU) of continuing pharmacy education (UPN 452-999-08-017-H01-P).

Any participant wanting to file a grievance with respect to any aspect of a continuing pharmacy education activity accredited by North American Center for Continuing Medical Education, LLC (NACCME), may contact John Savage, Director, Medical Education, NACCME, in writing at 300 Rike Drive, Suite A, Millstone Township, NJ 08535 or jsavage@naccme.com. The Director of Medical Education will review the grievance and respond within 30 days of receiving the written statement. If the participant is unsatisfied with the response, an appeal to the Vice President, Medical Education, NACCME, may be made for a second level of review.

Independent Clinical Reviewer: James M. Atkins, MD, Professor, Internal Medicine—Cardiology, Emergency Medicine, UT Southwestern Medical School, Dallas, Texas

Planning Committee

The planning committee comprises James M. Atkins, MD and C. Michael Gibson, MD; Mandy Daniel, the University of Kentucky College of Medicine; and Kristin Dickie, Mary Johnson, Randy Robbin, and John Savage, NACCME.

Financial Disclosure and Conflicts of Interest

According to the disclosure policy of the University of Kentucky College of Medicine and NAACME, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with relevant commercial companies related to this activity. All relevant conflicts of interest that are identified are reviewed for potential conflicts of interest. If a conflict is identified, it is the responsibility of the University of Kentucky College of Medicine and NAACME to initiate a mechanism to resolve the conflict(s). The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation.

All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

The faculty has reported the following:
Dr. Gibson: Grant/research support—Abbott Laboratories, Archemix Corporation, AstraZeneca, Baxter, CardioKinetix, Eli Lilly and Company,
FoldRx, Genentech, Inc, HeartScape Technologies, INO Therapeutics, LLC, Kai Pharmaceuticals, Novartis, Nuvelo, Point Biomedical Corporation,
Portola, sanofi-aventis U.S., Schering Plough; Speaker’s bureau—Schering Plough, The Medicines Company; Consultant—Angel Medical Systems,
Archemix Corporation, Ascenta Therapeutics, Atrium Medical Corporation, Bayer, Biogen IDEC, HeartScape Technologies, Inc, Momenta
Pharmaceuticals, PDL Pharmaceuticals, Portola, The Medicines Company, timi3 Systems, Schering Plough
Dr. Atkins disclosed no relevant financial relationships with any commercial interests.

Ms. Daniel, Ms. Dickie, Ms. Johnson, Mr. Robbin, and Mr. Savage have disclosed they have no relevant financial relationships with any commercial interests.

The University of Kentucky College of Medicine and NACCME requires faculty to inform participants whenever off-label/unapproved uses of drugs and/or devices are discussed in their presentations.

The faculty has disclosed that no off-label/unapproved uses of drugs and/or devices will be discussed.

Privacy Policy

NACCME protects the privacy of personal and other information regarding participants, educational partners, and joint sponsors. NACCME and our joint sponsors will not release personally identifiable information to a third party without the individual's consent, except such information as is required for reporting purposes to the appropriate accrediting agency.

NACCME maintains physical, electronic and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Copyright © 2008 by North American Center for Continuing Medical Education, LLC. All rights reserved. No part of this accredited continuing education activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the North American Center for Continuing Medical Education.

Grant Support

Supported by an educational grant from sanofi-aventis U.S and Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership.