Cases in Vascular Protection: Reducing Risk Factors-Case 3: Acute Coronary Syndrome

Faculty

Jean Nappi, PharmD
Professor of Pharmacy and Clinical Sciences
South Carolina College of Pharmacy, MUSC Campus
Professor of Medicine
Medical University of South Carolina

Lynne Wagoner, MD

Needs Statement

Mortality data continues to show that cardiovascular (CV) is responsible for approximately 36% of deaths in the United States.  Coronary heart disease causes 1 out of every 5 deaths.  In 2007, an estimated 700,000 Americans will have a new coronary attack and an additional 500,000 will have a recurrent attack.  Although in-hospital mortality from acute myocardial infarction (MI) declined from 1990 to 1999 (from 11.2% to 9.4%), the potential for further improvements still exists.   Prevention of coronary disease primarily involves lifestyle modifications to reduce the impact of hypertension, dyslipidemia and smoking.  In addition to being effective antihypertensive agents, angiotensin-converting enzyme (ACE) inhibitors have been associated with reduced mortality for patients with acute MI and left ventricular (LV) dysfunction. Pharmacologic management of ACS include ACE inhibitors, which may limit ventricular remodeling, known to occur after an acute MI.  Clinicians should follow best practice guidelines to ensure reduction of risk factors leading to a decrease in overall risk for CV disease and its related morbidity and mortality.

Target Audience

This program is designed to update Primary Care Physicians, Endocrinologists, Nephrologists, and Cardiologists on the management of cardiovascular disease progression and the long term benefits associated with optimal treatment plans for hypertension.

Objectives

1.  Define the term acute coronary syndrome (ACS);
2.  Explain the pathophysiologic basis for the use of angiotensin-converting enzyme (ACE) inhibitors in patients who have presented with ACS;
3.  Describe the role of ACE inhibitors in the acute, subacute, and long-term management of patients with ACS and stable coronary heart disease;
4.  Discuss the major clinical trials of ACE inhibitors in ACS and stable coronary heart disease that have contributed to the evidence-based treatment recommendations.

Accreditation

Medicine
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of Kentucky College of Medicine and CTI Clinical Trial & Consulting Services. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this educational activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Each physician should claim only those hours of credit actually spent in the educational activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

Faculty Disclosure

Dr. Nappi serves on the speaker’s bureau for AstraZeneca, Scios, The
Medicine Company, and University Pharmacotherapy Associates. She
is a consultant to Arca Discover. Dr. Wagoner serves on the speaker’s
bureau for Boston Scientific, GlaxoSmithKline, King Pharmaceuticals,
Medtronic, and Scios. She is also a consultant for CardioVascular
BioTherapeutics, Inc.

Activity Sponsorship