Therapeutic Options in Coronary Artery Disease (CAD) and Acute Coronary Syndrome (ACS)- No CME Available

Every year in the United States, 800 000 people suffer from an initial coronary event and 500 000 people suffer a recurrent coronary event. Management of patients suffering from coronary artery disease (CAD), and acute coronary syndrome (ACS) includes behavioral risk reduction strategies, interventional procedures (balloon angioplasty, artery stents, artery bypass), and medication therapy (antiplatelet agents, antithrombotic agents, inhibitors of clotting factors). With increasing specialization among surgeons and cardiologists, there is greater reliance on hospitalists to treat and manage hospitalized patients with CAD and ACS. In fact, at hospitals and academic centers nationwide, hospitalists are now at the forefront of comanaging surgical and interventional cardiology patients. Therefore, hospitalists must be knowledgeable in the procedures for assessing patients with possible CAD and ACS and be able to implement diagnostic and therapeutic measures to assess and treat patients with these cardiac issues.
To provide hospitalists with current data and guidelines regarding the treatment of CAD and ACS in hospitalized patients.
This activity is designed for hospitalists and residents interested in the field of consultative medicine. 
After completing the module, the participant should be able to:
1. Identify the pathophysiologic features of coronary artery disease and acute coronary syndrome.
2. Apply clinical guidelines to ACS severity stratification and subsequent treatment recommendations.
3. Recognize clinical situations that influence the choice of bare metal or drug eluting stent and coordinate decision making with interventional cardiology.
4. Use patient specific factors and institutional guidelines to prescribe pre- and post-procedural antiplatelet therapy.
5. Summarize clinical data on emerging anticoagulant and antiplatelet therapies for use in CAD.
Accreditation Statement:
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 University of Virginia School of Medicine, ASiM, and the Society of Hospital Medicine. The University of Virginia School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. 
Credit Designation Statement:
The University of Virginia School of Medicine designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Release date: September 22, 2015.         Expiration date: September 22, 2018. 
Estimated time to complete activity: 2 hours
Full Disclosure Policy Affecting CME Activities:
The University of Virginia School of Medicine, as an ACCME accredited provider, endorses and strives to comply with the Accreditation Council for Continuing Medical Education (ACCME) Standards of Commercial Support, Commonwealth of Virginia statutes, University of Virginia policies and procedures, and associated federal and private regulations and guidelines on the need for disclosure and monitoring of proprietary and financial interests that may affect the scientific integrity and balance of content delivered in continuing medical education activities under our auspices.
The University of Virginia School of Medicine requires that all CME activities accredited through this institution be developed independently and be scientifically rigorous, balanced and objective in the presentation/discussion of its content, theories and practices.
All faculty presenters participating in an accredited CME activity are expected to disclose relevant financial relationships with commercial entities occurring within the past 12 months (such as grants or research support, employee, consultant, stock holder, member of speakers bureau, etc.). The University of Virginia School of Medicine will employ appropriate mechanisms to resolve potential conflicts of interest to maintain the standards of fair and balanced education to the participant. Questions about specific strategies can be directed to the Office of Continuing Medical Education, University of Virginia School of Medicine, Charlottesville, Virginia.

The faculty and staff of the University of Virginia Office of Continuing Medical Education have no financial affiliations to disclose.

The following relationships have been reported for faculty of this activity: 

Leonard Feldman, MD, FACP, FAAP, SFHM (Chair) 
Assistant Professor of Medicine and Pediatrics 
Johns Hopkins University School of Medicine 
Med-Peds Urban Health Residency Program Director
Associate Program Director, Osler Medical Residency
Director, Comprehensive General Medicine Consult Service
Editor, Consultative and Perioperative Medicine Essentials for Hospitalists
Baltimore, Maryland
Dr Feldman reports having no significant financial or advisory relationships with corporate organizations related to this activity.
Michael Ragosta, MD 
Director, Cardiac Catheterization Laboratories
University of Virginia Health System
Albert M, Kate L, and Peter R Kaplan Professor of Medicine
Cardiovascular Division, University of Virginia
Charlottesville, Virginia
Dr Ragosta reports having no significant financial or advisory relationships with corporate organizations related to this activity.

Bartho Caponi, MD, FACP, FHM (Peer Reviewer)
Clinical Associate Professor
Division of Hospital Medicine
University of Wisconsin Hospital and Clinics
Madison, Wisconsin
Dr Caponi reports having no significant financial or advisory relationships with corporate organizations related to this activity.
Disclosure of Discussion of Non-FDA–Approved Uses for Pharmaceutical Products and/or Medical Devices
The University of Virginia School of Medicine, as an ACCME provider, requires that all faculty presenters identify and disclose any off-label uses for pharmaceutical and medical device products. The University of Virginia School of Medicine recommends that each physician fully review all the available data on new products or procedures prior to clinical use.
All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.


The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the University of Virginia School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Click here to download the references for this educational activity.


The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, a study program, and a CME post-test. All 3 sections must be completed to receive CME credit.


Supported by educational grants from Bristol-Myers Squibb Company and Pfizer, Inc.

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