Advances in the Management of Acute Coronary Syndrome (ACS): Updated Guideline Recommendations for Dual Antiplatelet Therapy

A continuing medical education activity sponsored by NAMCP and AAMCN.

This activity is an archive from the live session from the 2019 Spring Managed Care Forum. If you participated in the live session, you are not eligible for continuing education credits from this archive.

This activity is valid from July 1, 2019 to August 1, 2020

Instructions for CME/CNE: Complete the pre-test, listen to the audio and view the slides, complete the post test, complete the evaluation form and hit submit. You will be asked to enter your name and email address on the pre-test, evaluation and post-test. If you close your internet browser without completing the post test, you will have ONE more opportunity to complete. A score of 70% must be achieved on the post test to receive continuing education credits. If you do not pass the post test after two attempts, you will not be eligible to try again. Once you complete the evaluation form and score 70% or higher on your post test, you will automatically be given your certificate.

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Audience: This activity is intended for healthcare professionals practicing in managed care environments.

This presentation is supported by an educational grant from
AstraZeneca LP

Acute Coronary Syndrome (ACS) is a result from acute obstruction of a coronary artery. Consequences depend on degree and location of obstruction and range from unstable angina to non–ST-segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI), and sudden cardiac death. Depending on the results of an electrocardiogram and the determination of which condition (STEMI, NSTEMI, or UA) is occurring, physicians must decide whether to perform an angioplasty or treat the patient solely with pharmacological agents. When an angioplasty, also known as a percutaneous coronary intervention (PCI), is performed, there are recently approved oral antiplatelet medications available that can help prevent the risk of future cardiac events. Treatments can include antiplatelet drugs, anticoagulants, nitrates, beta-blockers, and, for STEMI, emergency reperfusion via fibrinolytic drugs, percutaneous intervention, or, occasionally, coronary artery bypass graft surgery. Oral antiplatelets are agents that will decrease platelet aggregation, inhibit thrombus formation and stabilize ACS patients. If the diagnosis shows suggestions of myocardial infraction, then thrombolytics, like an oral P2Y12 inhibitor, can be used. During long term therapy, there are strategies that prevent ischemic risk while avoiding excessive bleeding risk.

Upon completion of this activity, participants will be able to:

  • Evaluate the updated ACC/AHA guideline recommendations regarding the proper use and duration of dual antiplatelet therapy (DAPT) in acute coronary syndromes (ACS)

  • Identify strategies for patient selection for long-term antiplatelet therapy for myocardial infarction (MI) prevention

  • Analyze the duration of DAPT following ACS by examining patient specific factors to balance ischemic vs. bleeding risk of extended DAPT

  • Discuss the role of a multidisciplinary team to improve adherence and long-term persistence to antiplatelet therapies

  • Explore the evidence and data for secondary prevention following acute coronary syndrome

Faculty: Michael Miller, MD, FACC, FAHA
Professor of Cardiovascular Medicine, Epidemiology & Public Health
University of Maryland School of Medicine


Dr. Miller serves on an advisory board for Amarin. He was also on the steering committee for the REDUCE-IT clinical trial. His presentation has been peer reviewed for any bias.
  Planning Committee:
Bill Williams, MD has no relevant financial relationships to disclose.
Jeremy Williams has no relevant financial relationships to disclose.
Will Williams has no relevant financial relationships to disclose.
Jacqueline Cole, RN, MS, CMCN has no relevant financial relationships to disclose.

NAMCP and/or the presenter has copyright or has received permissions for use of materials provided in this activity.

Accreditation & Designation
The National Association of Managed Care Physicians (NAMCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

NAMCP designates this enduring material for a maximum of 1 AMA PRA Category I creditsTM.

The American Association of Managed Care Nurses (AAMCN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC).

Nurses who complete this activity and achieve a passing score will receive 1 hour in continuing
nursing credit.

This activity has been approved by the American Board of Managed Care Nursing for 1.0 contact hour toward CMCN recertification requirements.

This presentation is supported by an educational grant from
AstraZeneca LP

NAMCP and/or this website does not provide medical advice, diagnosis or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health related concern, consult with your physician or healthcare professional.

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