Steven Rothman, MD, FACC Associate Professor of Medicine Temple University Campus Chief, Cardiovascular Diseases Lankenau Hospital, MLH Heart Center Wynnewood, PA
Additional Content Development Faculty Joseph L. Blackshear, MD Professor of Medicine Division of Cardiovascular Diseases Mayo Clinic Jacksonville, FL
Joel C. Marrs, PharmD, FNLA, BCPS (AQ Cardiology), CLS Assistant Professor Skaggs School of Pharmacy and Pharmaceutical Sciences Department of Clinical Pharmacy University of Colorado Anschutz Medical Campus Aurora, CO
Albert Einstein CCME Reviewer Andrew Krumerman, MD Associate Professor of Clinical Medicine Albert Einstein College of Medicine Division of Cardiology Arrhythmia Service Montefiore Medical Center Bronx, NY
NOTE: This activity was presented as a live visiting faculty grand rounds series beginning on May 23, 2014. Participants who received credit for attending any of the live presentations are not eligible to receive credit for this online release.
Clinicians have the opportunity to reduce the risk of stroke in patients with atrial fibrillation (AF) by appropriately assessing patients’ risk for stroke and bleeding and providing optimal anticoagulation therapy for stroke prevention. New oral anticoagulants are poised to help close the gap in underuse of anticoagulation therapy in patients with AF. However, with 3 new oral anticoagulants available as alternatives to warfarin therapy for stroke prevention, clinicians face the dilemma of which agent to use for individual patients. Differences in the pharmacokinetic and pharmacodynamic profiles of new oral anticoagulants can significantly impact how these agents should be used for individual patients. The goal of this continuing education activity is to improve clinicians’ ability to follow best practices related to stroke prevention in patients with AF based on current evidence. This will ultimately lead to the best possible patient outcomes, including less stroke-related disability, dementia, and death. Program Developer/Facilitator
This activity is jointly provided by Albert Einstein College of Medicine and Montefiore Medical Center, and MCM Education.
This activity is intended for cardiologists, internal medicine and primary care clinicians, and other clinicians interested and involved in the treatment of patients with AF.
Upon completion of this educational activity, the participant should be able to:
Describe recent and future anticipated changes to clinical practice guidelines that reflect new best practices in the use of antithrombotic therapy for patients with AF.
Determine when a patient with AF is at risk for stroke using evidence-based risk scoring assessments.
Determine when a patient with AF is at risk for bleeding using evidence-based risk scoring assessments.
Discuss key differences in the pharmacologic profiles of the new and emerging oral anticoagulants that may impact selection of a specific agent for an individual patient with AF.
Review characteristics of compounds that can potentially reverse the anticoagulation activity of direct thrombin inhibitors and factor Xa inhibitors.
Facilitate a clinician-patient dialogue to gain input from patients with AF about their individual values regarding the potential benefits and risks of anticoagulant therapy.
The “Conflict of Interest Disclosure Policies” of Albert Einstein College of Medicine of Yeshiva University require that faculty participating in any CME activity and anyone in a position to influence content disclose to the audience any relationship(s) with a pharmaceutical or equipment company. Any presenter whose disclosed relationships prove to create a conflict of interest, with regard to their contribution to the activity, will not be permitted to present.
The Albert Einstein College of Medicine of Yeshiva University (Einstein) also require that faculty participating in any CME activity and anyone in a position to influence content disclose to the audience when discussing any unlabeled or investigational use of any commercial product, or device, not yet approved for use in the United States.
Contributors whose COIs are irresolvable are not permitted to participate in Einstein CME activities.
Joseph L. Blackshear, MD
Nothing to disclose.
Steven Rothman, MD
Grant Research: Medtronic, Inc.; Biotronic
Consultant: Janssen Pharmaceuticals, Inc.
Speakers Bureau: Janssen Pharmaceuticals, Inc.; Boehringer Ingleheim Pharmaceuticals, Inc.
Joel C. Marrs, PharmD
Nothing to disclose.
Andrew Krumerman, MD
Nothing to disclose.
The staff of the Center for Continuing Medical Education at Albert Einstein College of Medicine and Montefiore Medical Center and the staff of MCM Education have nothing to disclose.
This presentation includes discussion of unlabeled/investigational use of the following commercial products or devices: edoxaban, betrixaban, emerging vitamin K antagonists (eg, ATI-5923), and left atrial appendage occlusion devices (eg, Watchman, Lariat).
ACCME ACCREDITATION STATEMENT: This activity has been planned and implemented in accordance with the requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Albert Einstein College of Medicine of Yeshiva University, Montefiore Medical Center, and MCM Education. Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
ACCME CREDIT DESIGNATION STATEMENT: Albert Einstein College of Medicine of Yeshiva University designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit TM. Physicians should claim only the credit commensurate with the extent of their participation in each activity. Commercial Support Statements
Funded by independent educational grants from Boehringer Ingelheim Pharmaceuticals, Inc. and Daiichi Sankyo, Inc.
Presented by Albert Einstein College of Medicine & Montefiore Medical Center, Center for Continuing Medical Education and MCM Education.
The opinions expressed in this educational activity are those of the faculty and do not necessarily reflect the opinions or recommendations of their affiliated institutions, Albert Einstein College of Medicine & Montefiore Medical Center, Center for Continuing Medical Education, MCM Education, Boehringer Ingelheim Pharmaceuticals, Inc., or Daiichi Sankyo, Inc. Any medications, diagnostic procedures, or treatments discussed by the faculty should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.