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CME: Stroke Prevention in Atrial Fibrillation (Afib): A Focused Review of Highlights from the 2012 ACCP Guidelines on Antithrombotic Therapy and the Evolving Role of Novel, Oral Anticoagulants

ACCREDITATION EXPIRED: August 26, 2015

Activity Description / Statement of Need:

In this online CME self-learning program:

 

Atrial fibrillation (afib) is thought to be the most common dysrhythmia observed in clinical practice, affecting 2.2 million Americans – a prevalence that is expected to rise approximately sevenfold by the year 2050.  Patients experiencing new-onset afib may present with signs of hemodynamic instability, which qualifies as life-threatening emergency, and longer-term complications, particularly stroke. A therapeutic mainstay in preventing stroke in patients with chronic afib is antithrombotic therapy in the form of aspirin for low-risk patients and anticoagulation in moderate-to-high risk patients.

Compliance and better outcomes are also possible when patients have more knowledge and understanding of the need for treatment and risks of nonadherence to therapy – a consistent finding in both the anticoagulation-specific literature and non-.

 

Practitioners may be resistant to start anticoagulation in some patients if they are anticipated to be non-compliant or have little access to the appropriate level of monitoring. While these patients may be more difficult to manage, they may still require treatment with anticoagulants.

 

Compliance and better outcomes are also possible when patients have more knowledge and understanding of the need for treatment and risks of nonadherence to therapy – a consistent finding in both the anticoagulation-specific literature and non-.

 

Agenda:

 

Introduction, Disclosures

Incidence and risk

Standards of care and efficacy of warfarin: clinical evidence

Patient case

Barriers to anticoagulant use

Time in therapeutic range and goal of anticoagulation therapy, defined

Balancing stroke and bleeding risk

Guidelines for anticoagulant selection

Stroke prevention in AF

Overview and pharmacology of novel oral anticoagulants (NOACs)

Overview of phase III clinical trials in AF

Stroke v. systemic embolism: NOACs v. warfarin - what does the literature have to say?

Dosing of NOACs

Case studies

Assessing the intensity of anticoagultion effects

Periprocedural management of NOACs

NOACs: clinical implications

Adherence to therapy

Target Audience:

Healthcare professionals specializing in: outpatient cardiology, emergency medicine, internal medicine, and those who otherwise regularly treat patients with anticoagulants.


This program is supported by educational grants from Daiichi-Sankyo and Boehringer-Ingelheim.


Release Date: August 26, 2013 -- Expiration Date: August 26, 2015

Faculty: James Groce, PharmD, CACP

Agenda

Learning Objectives

By the end of the session the participant will be able to:

  • When given a patient case, determine whether chronic, indefinite anticoagulation is necessary and the best approach to the given patient.
  • Incorporate the ACCP recommendations and newer evidence in the management of patients with moderate-to-high risk chronic atrial fibrillation.
  • Given a patient case, develop strategies aimed at minimizing the competing risks of hemorrhage and recurrent thromboembolism.
  • Describe the evolving roles of novel, oral anticoagulants in relation to convention therapy.
  • Describe challenges to the successful anticoagulation management.

Accreditation

ACCREDITATION FOR THIS COURSE HAS EXPIRED. YOU MAY VIEW THE PROGRAM, BUT CME / CE IS NO LONGER AVAILABLE AND NO CERTIFICATE WILL BE ISSUED.


Faculty Disclosure and Resolution of COI

 As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

 

Faculty Disclosure:  James Groce, PharmD has received grant funding and/or consulting income and/or speaker's bureau income from Boehringer-Ingelheim, J&J, Sanofi-Aventis, Ortho-McNeil Janssen Pharma, Diagnostica-Stago.

 

Disclosures of Educational Planners: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC.

 

Commercial Support Disclosure: This program is supported by educational grants from Daiichi-Sankyo and Boehringer-Ingelheim.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.