Activity 3: Achieving Optimal Outcomes After ACS

CME certification of this program has expired. The program is still available for viewing, but is no longer eligible for CME credit.

Program Overview

Patients with acute coronary syndrome (ACS) are at high risk for recurrent events. Long-term epidemiologic studies demonstrate that 40% of patients suffer recurrent myocardial infarction (MI) or unstable angina, and 6% suffer sudden cardiac death within 3 years post-MI. The goal of secondary prevention is to reduce recurrent ischemic events and mortality in these high-risk patients.

Compelling evidence confirms that a comprehensive risk factor management strategy extends overall survival, improves quality of life, decreases the need for interventional procedures such as angioplasty and bypass grafting, and reduces the incidence of subsequent heart attack in patients with ACS. Despite the evidence, however, studies demonstrate that secondary prevention measures are not adequately implemented, and many ACS patients are not achieving recommended lifestyle and risk factor goals. Patients are not always prescribed optimal drug therapy, nor do they always receive advice regarding lifestyle changes and access to cardiac rehabilitation. Consequently, there is significant potential for improvement.

Effective secondary prevention and long-term management of ACS requires the early adoption and continued implementation of evidence-based practices. The American College of Cardiology and the American Heart Association have published secondary prevention guidelines that span the continuum of ACS and include recommendations for the use of antiplatelet agents, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, lipid-lowering agents and cardiac rehabilitation. The overall goal of this educational activity is to improve outcomes in ACS patients by providing family physicians with targeted information and tools to facilitate the application of evidence-based secondary prevention recommendations in clinical practice.

Intended Audience

This continuing medical education program is intended for family physicians and other primary care providers who care for patients with acute coronary syndrome (ACS).

Learning Objectives

After completing this activity, family physicians will be better able to:

  • Implement evidence-based secondary prevention recommendations in post-ACS patients
  • Explain the role and rationale for use of the five major classes of medication prescribed at discharge post-ACS
  • Address patient concerns in the period immediately following discharge post-ACS
  • Appreciate the benefits and practice of cardiac rehabilitation in post-ACS patients
  • Assess and monitor patients for psychosocial issues that may impact post-ACS outcomes

Faculty

Sharon K. Duffy, RN, MS, CRRN
Manager, Integrative Medicine
Madonna ProActive Health & Fitness
Lincoln, NE

Clare A. Hawkins, MD, MSc, FAAFP
Family Medicine Residency Director
San Jacinto Methodist Hospital
Baytown, TX

Kim A. Eagle, MD, MACC
Albion Walter Hewlett Professor of Internal Medicine
Director, Cardiovascular Center
University of Michigan Health System
Ann Arbor, MI

Planning Committee

Sharon K. Duffy, RN, MS, CRRN
Manager, Integrative Medicine
Madonna ProActive Health & Fitness
Lincoln, NE

Kim A. Eagle, MD, MACC
Albion Walter Hewlett Professor of Internal Medicine
Director, Cardiovascular Center
University of Michigan Health System
Ann Arbor, MI

Clare A. Hawkins, MD, MSc, FAAFP- Chair
Family Medicine Residency Director
San Jacinto Methodist Hospital
Baytown, TX

Jasen W. Gundersen, MD, MBA, SFHM
Inpatient Clinical Services Chief
Division Chief, Hospital Medicine
UMass Memorial Medical Center
Clinical Associate Professor of Medicine and Family & Community Health
UMass Medical School
Worcester, MA

CME Accreditation

This activity, Achieving Optimal Outcomes After ACS, has been reviewed and is acceptable for up to 1 Prescribed credit(s) by the American Academy of Family Physicians. This activity conforms to the AAFP criteria for evidence-based CME clinical content. AAFP accreditation begins November 15, 2010. Term of approval is for 2 year(s) from this date with the option of yearly renewal.

The Evidence-Based CME clinical content designated for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since some clinical research is ongoing, the American Academy of Family Physicians recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Family Physicians designates this education activity for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Agenda

Introduction and Opening Remarks

Module 1: Discharge and Early Risk Stratification

Module 2: ACS Risk Factor Management

Module 3: Demystifying Cardiac Rehabilitation

Closing Remarks

Disclosures

It is the policy of the AAFP that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflict of interests and, if identified, they are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity.

The AAFP and MedEd Architects, LLC staffs have indicated that they have no relationships to disclose relating to the subject matter of the activity. Dr. Eagle and Ms. Duffy returned disclosure forms indicating that they have no financial interest in or affiliation with any commercial supporter or providers of any commercial services discussed in this educational material. Dr. Hawkins returned a disclosure form indicating that he assisted Boehringer Ingelheim with manuscript preparation and validation for a chronic obstructive pulmonary disease (COPD) screener.

 

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