Acute Coronary Syndrome

Optimizing the Management of Acute Coronary Syndrome in the Primary Care Setting

Acute coronary syndrome (ACS) encompasses unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) and is characterized by episodes of chest pain at rest or with minimal exertion that are increasing in frequency or severity, often with dynamic electrocardiography changes. These life-threatening disorders are a major cause of emergency medical care and hospitalization in the United States. In 2004, the National Center for Health Statistics reported 1,565,000 hospitalizations for a primary or secondary diagnosis of ACS, 669,000 for UA, and 896,000 for myocardial infarction (MI).¹

The prevalence of ACS ensures that family physicians will encounter patients with UA/NSTEMI in outpatient and emergency department settings. Evidence-based guidelines are available to assist physicians in the proper evaluation and management of these patients. Application of the evidence-based recommendations, combined with carefully reasoned clinical judgment, can reduce the risk of cardiac damage and death in patients who present with symptoms suggestive of UA/NSTEMI.¹

1. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction. J Am Coll Cardiol 2007;50:e1-e157.

Objectives

Based on identified educational needs, this series will provide content specifically directed at:

• Improving the identification, management and outcomes of patients with ACS seen by family physicians
• Supporting appropriate risk stratification of patients with ACS in the family medicine setting
• Reviewing risk factors, treatment goals and therapeutic strategies integral to the comprehensive care of ACS patients
• Addressing major barriers and challenges that deter effective management of ACS in primary care
• Improving cultural competency in the recognition and management of ACS
• Facilitating physician-patient communication with regard to ACS risk, presentation and treatment
• Providing strategies for maintaining patient compliance and adherence

After completing this 4-part series, family physicians will be better able to:

• Identify and manage patients with ACS
• Appropriately stratify ACS patients according to individual risk
• Apply evidence-based treatment recommendations across the ACS continuum of care
• Develop a comprehensive management plan to lower risk for recurrent CV events
• Address major barriers and challenges that deter effective management of ACS in primary care
• Recognize cultural and gender influences with regard to the presentation and management of ACS
• Communicate with patients concerning their ACS risk, presentation of ACS, and importance of compliance with recommended treatment

Activities

Activity 1: Chest Pain: What to do with ACS?

Activity 2: Antiplatelet Therapy in ACS: What's Best Practice?

Activity 3: Achieving Optimal Outcomes After ACS

Activity 4: Case Studies in ACS

Acknowledgment of Support

This program is supported by an educational grant from Daiichi Sankyo, Inc. and Eli Lilly and Company.