The Conundrum of Managing Chronic Coronary Disease: DPI or DAPT?

Program Dates: November 19th, 2021 - November 18th, 2022
Credits: 1.0 AMA PRA Category 1 Credit™

The Conundrum of Managing Chronic Coronary Disease: DPI or DAPT?

Program Overview

This CME program is derived from content presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2021 Conference. Long-term protection from thrombotic/ischemic complications in patients with chronic coronary disease is an increasingly important topic given the aging of the population and the improved survival rates after an acute coronary syndrome (ACS). There are emerging data that support both dual antiplatelet therapy (DAPT) and dual pathway inhibition (DPI) for these patients. In this CME activity, chaired by Deepak L. Bhatt, MD, expert faculty will evaluate that evidence and apply it to clinical decision-making to support safe antithrombotic treatment in specific case scenarios.

Target Audience

Interventional cardiologists, clinical cardiologists, vascular medicine specialists, and other healthcare professionals involved in the management of patients with chronic coronary disease

Learning Objectives

  1. Review current anti-thrombotic and anti-platelet science, including mechanism of action, and how that science informs a selection of DAPT or DPI in patients with chronic coronary disease.
  2. Explain and prioritize the concomitant clinical issues in patients with chronic coronary disease (such as concomitant PAD or AF) that help determine the choice between DAPT and DPI.
  3. Describe the differences in rheology of blood flow in coronary vs peripheral arteries and explain the impact of those differences on choice of therapy between DAPT and DPI.
  4. Update treatment plans to apply the most current data to effective, streamlined, multidisciplinary and interprofessional management of chronic coronary disease.


I. Understanding the Options: DAPT or DPI in Patients with Chronic Coronary Disease
II. Disease State and Comorbidities: How Specific Clinical Issues Drive Therapeutic Decision-making in Patients with Chronic Coronary Disease
III. Go With the Flow? Differential Rheology in the Coronary and Peripheral Vascular Beds
IV. Case Studies and Faculty Discussion: Making the “Right” Decision in the Absence of Head-to-Head Trials


Deepak L. Bhatt, MD, MPH
Professor of Medicine
Harvard Medical School
Executive Director of Interventional Cardiovascular Programs
Brigham and Women’s Hospital Heart and Vascular Center
Boston, Massachusetts


Marc P. Bonaca, MD, MPH
Director of Vascular Research
University of Colorado School of Medicine
Executive Director
CPC Clinical Research
Aurora, Colorado


Paul A. Gurbel, MD
Sinai Center for Thrombosis Research and Drug Development
Sinai Hospital of Baltimore
Baltimore, Maryland



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:
Deepak L. Bhatt, MD Grant/Research Support: Abbott; Afimmune Limited; Amarin Corporation; Amgen Inc.; AstraZeneca Pharmaceuticals; Bayer AG; Boehringer Ingelheim International GmBH; Bristol-Myers Squibb; Cardax, Inc.; CellProthera; Cereno Scientific AB; Chiesi USA, Inc.; CSL Behring; Eisai Co., Ltd.; Ethicon; F. Hoffmann-La Roche Ltd; Ferring Pharmaceuticals; Forest Laboratories; Fractyl Health, Inc.; Garmin Ltd.; HLS Therapeutics, Inc.; Idorsia Pharmaceuticals Ltd; Ironwood Pharmaceuticals; Ischemix, Inc.; Janssen Global Services, LLC; Lexicon; Lilly; Medtronic; MyoKardia, Inc.; NirvaMed, Inc.; Novartis AG; Novo Nordisk A/S; Owkin, Inc.; Pfizer Inc.; PhaseBio Pharmaceuticals, Inc.; PLx Pharma Inc.; Regeneron Pharmaceuticals; Sanofi; Synaptic; The Medicines Company; 89Bio, Inc.
Marc P. Bonaca, MD Grant/Research Support: Amgen Inc.; ARCA BioPharma; AstraZeneca Pharmaceuticals; Bayer AG; Better Therapeutics, Inc.; Cell Research; Everly Well, Inc.; Janssen Global Services, LLC; NovoNordisk A/S; Osiris Therapeutics, Inc.
Paul A. Gurbel, MD Consultant/Advisor: Adeno Biosciences; Baron & Budd, PC; Bayer AG; Cleveland Clinic; Innovative Science Solutions, Inc.; Janssen Global Services, LLC; North American Thrombosis Forum; OtiTopic; WebMD LLC; Wolters Kluwer N.V

Grant/Research Support: Amgen Inc.; Bayer AG; Haemonetics Corporation; Hikari Dx, Inc.; Instrumentation Laboratory Company; Janssen Global Services, LLC; Novartis AG; Novartis AG; OtiTopic; Precision BioLogic

Planners and Peer Reviewers

Timothy Hayes, MD, PhD; Kim Cheramie, MSN, RN-BC; Chelsey Benedek and Nicole McMenamin 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 Statement

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.


Credit Designation Statements

AcademicCME designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Financial Support

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:

  1. Read the learning objectives, accreditation information and faculty disclosures at the beginning of this activity.
  2. Complete the Pre-Activity Questions
  3. Read or Review the activity content.
  4. Complete the Post-Activity Test Questions and Evaluation.
  5. Learners who receive a grade of 66% or better on the Post-Activity Test Questions and complete the Evaluation will receive appropriate credit as indicated (CME, CNE, and/or CPE credit).
  • CME and CNE credit will be issued appropriate certificate of completion.
  • Others may request a “certificate of completion”.
  1. Learners should claim only the credit commensurate with the extent of their participation in the activity.

CE Inquiries/Special Needs

For all CE inquiries or special needs, please contact [email protected].


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