The optimal duration and intensity of dual antiplatelet therapy (DAPT) remains unsettled. This program will address challenges for clinicians in using antiplatelet therapy, with the overarching focus on balancing the need to reduce ischemic risk and lower bleeding risk. There will be emphasis throughout the program on the need to personalize the use of antiplatelet therapy—tailoring therapy to risk profile. Format will consist of 2 short presentations summarizing clinical evidence, a summary perspective, followed by 2 case discussions.
CME ACCREDITATION AND DESIGNATION
Voxmedia LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Voxmedia LLC designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Individuals should claim only those credits that he/she actually earned in the educational activity.
To obtain CME credit for this activity, participants must review all CME information, view all presentations in their entirety, and complete the Activity Evaluation Form. If you have any questions, please contact Tammy Thompson at tthompson@voxmedia.us
Introduction
George Dangas, MD, PhD (Chair)
Antiplatelet Therapy for Patients with Diabetes Undergoing PCI
Deepak L. Bhatt, MD, MPH
When to Shorten DAPT: Key Messages
George Dangas, MD, PhD
Finding the Sweet Spot: Balancing Reducing Ischemic Risk and Reducing Bleeding Risk with Antiplatelet Therapy
Deepak L. Bhatt, MD, MPH
Case #1: Bleeding and Ischemic Complications from the EXCEL Trial
Gregg Stone, MD
Case #2: Antiplatelet Therapy Disruption Challenges After Stenting
George Dangas, MD, PhD
By the end of this program, participants should be able to:
• Evaluate the effectiveness of potent P2Y12 inhibition in patients with diabetes mellitus
• Describe scenarios for consideration of full-term or extended-term dual antiplatelet therapy (DAPT)
• Recognize patients for potential use of short-term DAPT
• Identify multiple considerations for best use of antiplatelet therapy after PCI
This educational activity is intended for clinicians who manage patients with cardiovascular disease.
Voxmedia strives to ensure fair-balance, independence, objectivity, and scientific rigor in all directly or jointly sponsored educational activities. All prospective faculty are required to disclose to Voxmedia all financial relationships for the preceding 24 months (1) with any commercial interest producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients AND (2) with any commercial supporters prior to participating in the planning of an activity or developing content. Only after Voxmedia mitigates all financial relationships may faculty receive approval to participate, and are expected to contribute evidence-based material. Faculty are required to indicate areas of their presentation that are based on professional opinion vs. guidelines, meta-analysis. All information submitted will be peer-reviewed. The intent of this disclosure is not to prevent faculty from participating, but rather to provide learners with information on which they can make their own judgment of commercial bias. Voxmedia will disclose to learners that all relevant financial relationships have been mitigated in either written materials, visually and/or verbally. It remains for the audience to determine whether the speaker's interests or relationships may influence the presentation. Speakers must make a meaningful disclosure to the audience of their discussions of any unlabeled or investigational use(s) of drugs or devices.
Deepak L. Bhatt, MD, MPH, has disclosed the following relevant financial relationships:
Advisory Board: Boehringer Ingelheim; Cardax; CellProthera; Cereno Scientific; Elsevier Practice Update Cardiology; Janssen; Level Ex; Medscape Cardiology; MyoKardia; NirvaMed; Novo Nordisk; PhaseBio; PLx Pharma; Regado Biosciences; Stasys
Board of Directors: Boston VA Research Institute; Society of Cardiovascular Patient Care; TobeSoft
Chair: Inaugural Chair, American Heart Association Quality Oversight Committee
Data Monitoring Committees: Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott); Boston Scientific (Chair, PEITHO trial); Cleveland Clinic (including for the ExCEED trial, funded by Edwards); Contego Medical (Chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo); Novartis; Population Health Research Institute
Honoraria: American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Chair, ACC Accreditation Oversight Committee); Arnold and Porter law firm (work related to Sanofi/Bristol Myers Squibb clopidogrel litigation); Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim; AEGIS-II executive committee funded by CSL Behring); Belvoir Publications (Editor in Chief, Harvard Heart Letter); Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees); Cowen and Company; Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals); HMP Global (Editor in Chief, Journal of Invasive Cardiology); Journal of the American College of Cardiology (Guest Editor; Associate Editor); K2P (Co-Chair, interdisciplinary curriculum); Level Ex; Medtelligence/ReachMD (CME steering committees); MJH Life Sciences; Piper Sandler; Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer); Slack Publications (Chief Medical Editor, Cardiology Today’s Intervention); Society of Cardiovascular Patient Care (Secretary/Treasurer); WebMD; (CME steering committees)
Other: Clinical Cardiology (Deputy Editor); NCDR-ACTION Registry Steering Committee (Chair); VA CART Research and Publications Committee (Chair)
Research Funding: Abbott; Afimmune; Amarin; Amgen; AstraZeneca; Bayer; Boehringer Ingelheim; Bristol Myers Squibb; Cardax; CellProthera; Cereno Scientific; Chiesi; CSL Behring; Eisai; Ethicon; Faraday Pharmaceuticals; Ferring Pharmaceuticals; Forest Laboratories; Fractyl; Garmin; HLS Therapeutics; Idorsia; Ironwood; Ischemix; Janssen; Lexicon; Lilly; Medtronic; MyoKardia; NirvaMed; Novartis; Novo Nordisk; Owkin; Pfizer; PhaseBio; PLx Pharma; Regeneron; Roche; Sanofi; Stasys; Synaptic; The Medicines Company; 89Bio
Royalties: Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease)
Site Co-Investigator: Abbott; Biotronik; Boston Scientific; CSI; Philips; St. Jude Medical (now Abbott); Svelte
Trustee: American College of Cardiology
Unfunded Research: FlowCo; Merck; Takeda
George Dangas, MD, PhD, has disclosed the following relevant financial relationships:
Research Funding to Institution: Abbott Laboratories; AstraZeneca; Bayer; Boston Scientific; Daiichi-Sankyo, Medtronic
Gregg Stone, MD, has disclosed the following relevant financial relationships:
Research Funding to Institution: Abbott
Voxmedia:
John F. Kocsis, PhD
President
Hazlet, New Jersey, United States
John F. Kocsis, PhD, has disclosed no relevant financial relationships.
This program was supported by an educational grant from AstraZeneca Pharmaceuticals.