Release Date:  June 1, 2009
Expiration Date:  June 1, 2010

This activity is intended for emergency physicians, nurses and nurse practitioners, cardiologists, hospitalists, physician assistants and other specialists who care for patients presenting in emergency settings with acute coronary syndromes (ACS).

The following learning objectives have been based on a literature review and input from key opinion leaders. Upon completion of this activity, participants will be able to:

Describe how the updated ACC/AHA guidelines for the management of STEMI and NSTEMI differ from previous guidelines.

Apply the updated ACC/AHA guidelines when treating patients presenting with NSTEMI and STEMI.

Assess ways to dose antiplatelet and anticoagulant therapy to maximize efficacy and minimize bleeding risks for those undergoing PCI and for those undergoing fibrinolysis.

Summarize the optimal dose and duration of antiplatelet therapy for patients undergoing PCI.

Richard V. Aghababian, M.D., F.A.C.E.P., is the Associate Dean of Continuing Medical Education at the University of Massachusetts Medical School in Worcester and a Professor of Emergency Medicine at the University of Massachusetts Memorial Medical Center. From 1992-2007, he was chairman of the Department of Emergency Medicine at the Medical Center. He is board certified in emergency medicine and a Diplomat of the American Board of Emergency Medicine and a Fellow of the American College of Emergency Physicians.

A graduate of Harvard College and the University of Massachusetts Medical School, Dr. Aghababian has served as president of the Worcester District Medical Society, the Massachusetts College of Emergency Physicians, the American College of Emergency Physicians, and the Society for Airway Management. He has served MMS in a number of capacities, including membership on its District Leadership Council and House of Delegates, and its committees on Finance, Nominations, Physician Preparedness, Global Medicine, and Medical Education. An editor of several textbooks and a widely-published author and lecturer on topics in emergency medicine, disaster response, and preparedness, Dr. Aghababian has received numerous honors and awards for his contributions to medicine and the community from a number of organizations.

Dr. Deborah Diercks joined the faculty in Emergency Medicine at University of California, Davis Medical Center in 1998. She completed her residency at University of Cincinnati Medical Center. Her clinical research interests have included the diagnosis and management of patients with suspected acute coronary syndrome and congestive heart failure who present to the emergency department. She has been involved in both single center and multi-center trials in both of these areas.

Dr. Diercks has collaborated in studies involving the identification of acute coronary syndrome in the emergency department, including the use of cardiac injury markers and novel electrocardiogram techniques, and has done work evaluating observation unit care of the chest pain patient. She has participated in therapeutic trials for congestive heart failure and acute coronary syndrome. She was on the Steering Committee for Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) Registry. Currently she is a member of the American Heart Association Western Regional MI task force and on the Research and Publication Committee for the NCDR ACTION-GWTG registry.

Over the past several years, Dr. Diercks has participated in a number of national acute coronary syndrome symposia. She is a member of the Emergency Medicine Cardiac Research and Education Group and the American College of Emergency Physicians Clinical Guidelines Committee.

It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflict of interest is resolved by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.

Dr. Aghababian has no relevant commercial interests to disclose.

Dr. Diercks has participated on speakers' bureaus for sanofi-aventis and Bristol-Myers Squibb and served as a consultant for sanofi-aventis, Bristol-Myers Squibb, Astellas, Heartscape and The Medicines Company.

Physicians:  This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of AKH Inc. and CME-University.

AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians. AKH Inc. designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurses  AKH Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC-COA).

AKH Inc. designates this educational activity for 1.0 contact hour (0.1 CEU). Accreditation applies solely to educational activities and does not imply approval or endorsement of any commercial product by the ANCC-COA.

There are no fees to participate and receive credit. This slides and audio activity should take approximately 1 hour to complete. Participants must listen to the presentation, score 70% or better on the post-test, and complete a program evaluation to be awarded credit.

This educational activity is supported by an educational grant from Bristol-Myers Squibb Company and Sanofi-Synthelabo