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The benefits of dual antiplatelet therapy in patients presenting with acute coronary syndrome (ACS) prior to coronary angiography and possible percutaneous coronary intervention (PCI) are proven. However, this practice carries the risk of excess bleeding in the event that these patients require coronary artery bypass graft (CAGB) surgery. Withholding clopidogrel until confirmation of affected vascular anatomy, or discontinuation of clopidogrel therapy 5-7 days prior to elective CABG surgery, are the most reliable ways to overcome the risk of excessive bleeding. However, these are not always practical in the clinical setting. There is also an increasingly recognized need to implement appropriate therapies to reduce risk of thromboembolic events following both CABG and valve replacement surgery.
This webcourse will provide evidence supporting the use of antiplatelet therapy in acute ACS patients and will discuss the current guidelines and recommendations to minimize bleeding risk in these patients requiring CABG. It will also provide valuable insights regarding the use of post-procedural antiplatelet therapy to minimize the risk of thromboembolic events following CABG and valve replacement surgeries. In this dynamic webcourse, faculty members will discuss the current practices, conundrums, and controversies related to antiplatelet therapy in cardiac surgery and provide valuable evidence and insights to make informed decisions about your patients.
| Faculty | Faculty Disclosures |
| Robert W. Emery, MD (Chair) Director of Cardiovascular & Thoracic Surgery St. Joseph's Hospital Editor-in-Chief, Journal of Heart Valve Disease St Paul, MN |
Robert W. Emery, MD Speaker: St. Jude Medical; Medtronic // Advisor: ATS Medical; Kipps Bay Medical // Stock: GE; Medtronic; Pfizer; Wyeth; SJM; ATS Medical; CryoLife; Cardica; Boston Scientific; Merck; Tyco |
| Christopher P. Cannon, MD, FACC Senior Investigator, TIMI Study Group Brigham and Women's Hospital Boston, MA |
Christopher P. Cannon, MD, FACC Research/Grants: Accumetrics; AstraZeneca; Bristol-Myers Squibb/Sanofi Partnership; GlaxoSmithKline; Merck; Merck/Schering-Plough Partnership // Clinical Advisor: Automedics Medical Systems |
| M. Salik A. Jahania, MD Associate Professor of Surgery Associate Program Director, Cardiothoracic Residency Division of Cardiothoracic Surgery Wayne State University School of Medicine Detroit, MI |
M. Salik A. Jahania, MD Speaker: Karmanos Cancer Institute; Scios Inc. |
| Additional content development by: Robert M. Mentzer, Jr, MD Professor of Surgery and Physiology Dean, Wayne State University School of Medicine Detroit, MI |
Robert M. Mentzer, Jr, MD Consultant: Hesperion US Inc., Boehringer Ingelheim Pharmaceuticals // Data Safety Monitoring Committee: Neuran Pharmaceuticals |
The following non-faculty content contributors reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Barry Watkins, PhD; Stephanie Stowell, MPhil; Dana Simpler, MD; Donna Fucello; Brad Pine: Nothing to Disclose
This program was developed for cardiothoracic surgeons and medical professionals who care for patients undergoing cardiothoracic surgery.
This activity was designed to address the following IOM competency:
Upon completion of this activity, participants should understand and demonstrate the ability to:
Introduction:
Robert Emery, MD (Chair)
Issues in the Management of Acute ACS Patients Requiring CABG:
Christopher Cannon, MD, FACC
Faculty Discussion
Optimizing Management of Patients Following Cardiac Surgery:
M. Salik A. Jahania, MD
Faculty Discussion
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The Potomac Center for Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Potomac Center for Medical Education designates this educational activity for a maximum of 1.0 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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All persons in a position to control the content of a continuing medical education program sponsored by the Potomac Center for Medical Education are required to disclose any relevant financial relationships with any commercial interest to PCME as well as to learners. All conflicts are identified and resolved by PCME in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners. Disclosures will be made known to the participants prior to the activity.
The content of this activity was vetted by an external medical reviewer to assure objectivity and that the activity is free of commercial bias.
The contents of some CME/CE activities may contain discussions of non-approved or off label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.
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