Heart disease continues to be the leading cause of mortality in Europe. Despite advances in prevention and therapy, each year cardiovascular disease (CVD) causes over 1.8 million deaths in the European Union (EU). CVD accounts for 45% of all deaths in Europe and 37% of all deaths in the EU, is the main cause of death in men in all but 12 countries of Europe, and is the main cause of death in women in all but two countries. Acute coronary syndromes (ACS) comprise a substantial portion of these grim statistics, and better care for ACS patients could improve clinical and economic outcomes in the EU. While evidence-based society guidelines recommend aggressive dual antiplatelet therapy (DAPT) for such patients, contemporary practice data on both sides of the Atlantic indicate that DAPT is underutilized both early after an index MI and for evidence-grounded durations of therapy. In addition, in 2019 new data were published that demand re-evaluation of oral antiplatelet drug choice and of the role of long-term aspirin therapy in secondary prevention of ACS. Education of all stakeholders in ACS/MI care—particularly interventional cardiologists—about the guidelines and their basis, and about improving practice to reflect recommendations for care, especially around DAPT, can improve outcomes in ACS.
The target audience includes cardiologists (clinical and interventional) and other healthcare providers engaged in the care of ACS and its secondary prevention
I. Overview of Controversies in Secondary Prevention of ACS
II. The Foundational Role of Antiplatelet Therapy in Secondary Prevention of ACS
III. Risk Stratification for Secondary Ischemia vs Bleeding Complications with Antiplatelet Therapy
IV. Is the Acetylsalicylic Acid Component of DAPT Required for the Duration?
V. What is the clinical impact of antiplatelet agent choice in secondary prevention? An analysis of ISAR-REACT 5
- Describe the latest evidence-based guideline recommendations for secondary prevention of ACS/MI
- Review the foundational role of antiplatelet therapy in secondary prevention of ACS/MI and manage their patients accordingly, with appropriate attention to risk benefit balance
- Discuss the pertinent findings of recent trials of anti-platelet therapy in ACS, placing them in the context of prior data, established practice, and current guidelines
Disclosures of Conflict of Interest
It is the policy of AcademicCME that all faculty, instructors, and planners disclose real or apparent conflicts of interest relating to the topics of this educational activity.
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 CE activity:
|Faculty||Relationship Identified With:|
|Charles V. Pollack Jr., MA, MD||Grant/Research Support: AstraZeneca Pharmaceuticals; Boehringer Ingelheim International GmbH; CSL Behring
Tobias Geisler, MD, MHBA, FESC
|Consultant/Advisor: AstraZeneca Pharmaceuticals; Bayer AG
Grant/Research Support: Bayer AG; Bristol Myers Squibb Company
Speaker’s Bureau: AstraZeneca Pharmaceuticals; Bayer AG; Boehringer Ingelheim International GmbH; Bristol Myers Squibb Company; Chiesi; Daiichi Sankyo Company Ltd.; Ferrer Pharma; Pfizer, Inc.
|Philippe Gabriel Steg, MD||Grant/Research Support: Bayer AG; Sanofi; Servier Laboratories
Speaker’s Bureau: Amarin Corporation; Amgen Inc.; AstraZeneca Pharmaceuticals; Bayer AG; Boehringer Ingelheim International GmbH; Bristol Myers Squibb Company; Idorsia Pharmaceuticals Ltd.; Mylan Inc.; Novo Nordisk; Novartis Pharmaceuticals Corporation; Pfizer, Inc.; Regeneron Pharmaceuticals; Sanofi; Servier Laboratories
|Robert Storey BSc, BM, DM||Consultant/Advisor: Amgen Inc.; AstraZeneca Pharmaceuticals; Bayer AG; Bristol Myers Squibb Company; GylCardial Diagnostics; Haemonetics Corporation; Portola Pharmaceuticals; Thromboserin Ltd
Grant/Research Support: AstraZeneca Pharmaceuticals; Bayer AG; Bristol Myers Squibb Company; Pfizer, Inc.
Speaker’s Bureau: AstraZeneca Pharmaceuticals; Bayer AG; Bristol Myers Squibb Company; Pfizer, Inc.
Uwe Zeymer, MD
|Speaker’s Bureau: Amgen Inc.; AstraZeneca Pharmaceuticals; Bayer AG; Bristol Myers Squibb Company; Boehringer Ingelheim International GmbH; Pfizer, Inc.; Ferrer Pharma; Novartis Pharmaceuticals Corporation; Sanofi|
Planners and Peer Reviewers
Timothy Hayes, MD, PhD; Kim Cheramie, MSN, RN-BC; Emma Boring; Nicole Brestowski and Chelsey Benedek hereby state that they or their spouse/life partner do not have any financial relationships to products or devices with any commercial interests related to the content of this activity of any amount during the past 12 months.
Accreditation and Credit Designation Statements
In support of improving patient care, AcademicCME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. AcademicCME designates this live material for a maximum of 1.50 AMA PRA Category 1 Credits TM.
The event “Controversies in Antiplatelet Therapy for the Secondary Prevention of Cardiovascular Events” is accredited by the European Board for Accreditation in Cardiology (EBAC) for 1.50 hours of External CME credits. Each participant should claim only those hours of credit that have actually been spent in the educational activity. EBAC works according to the quality standards of the European Accreditation Council for Continuing Medical Education (EACCME), which is an institution of the European Union of Medical Specialists (UEMS).”
This activity has been supported by an independent educational grant from AstraZeneca Pharmaceuticals
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. AcademicCME and AstraZeneca Pharmaceuticals do not recommend the use of any agent outside of the labeled indications.
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.
Method of Participation
In order to claim credit, participants must complete the following:
- Read the learning objectives, accreditation information and faculty disclosures at the beginning of this activity.
- Complete the Pre-Activity Questions.
- Read or Review the activity content.
- Complete the Post-Activity Test Questions and Evaluation.
- Healthcare providers who receive a grade of 70% or better on the Post-Activity Test Questions and who complete the Evaluation will receive a CME/CNE Certificate.
- All other participants who receive a grade of 70% or better on the Post-Activity Test Questions and who complete the Evaluation will receive a Certificate of Participation.
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