The American Journal of Cardiology Editor's Roundtable

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Role of Stents in Patients with Stable CHD

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Acknowledgment

 

This CME activity is supported by an educational grant from Abbott Vascular, Abbott Park, IL.  The article is based on a discussion among the faculty originally held on 3-12-09 and updated on 10-25-10.  

 

Disclosures

 

Dr. Friedewald: honoraria/speaker – Novartis, East Hanover, NJ.  Dr. Boden: honoraria/speaker: CV Therapeutics, Palo Alto, CA; sanofi-aventis, Bridgewater, NJ; Abbott Laboratories.  Dr. Stone: scientific advisory board and honoraria – Abbott Vascular, Santa Clara, CA; Boston Scientific, Natick, MA; consultant – The Medicines Company, Parsippany, NJ; AstraZeneca; Bristol Meyers Squibb; Eli Lilly.  Dr. Yancy: no relevant financial relationships to disclose,  Dr. Roberts: honoraria/speaker – Merck-Schering Plough, Whitehouse Station, NJ; AstraZeneca, Wilmington, DE; Novartis, Bridgewater, NJ

 

Faculty

 

Vincent E. Friedewald, MDa*

William E. Boden, MDb

Gregg W. Stone, MDc

Clyde W. Yancy, MDd

William C. Roberts, MDe

 

aModerator and Associate Editor, American Journal of Cardiology. Research Professor, University of Notre Dame, Notre Dame, IN.  bClinical Chief, Division of Cardiovascular Medicine Professor of Medicine and Preventive Medicine University at Buffalo, State University of New York School of Medicine and Biomedical Sciences and Public Health, Buffalo, NY.  cProfessor of Medicine Columbia University, Director of Cardiovascular Research and Education Center for Interventional Vascular Therapy Columbia University Medical Center New York City, NY.  dMedical Director, Baylor Heart & Vascular Institute Chief, Cardiothoracic Transplantation Baylor University Medical Center Dallas, Texas.  eEditor-in-Chief, The American Journal of Cardiology and Baylor University Medical Center Proceedings Executive Director, Baylor Heart and Vascular Institute, Baylor University Medical Center Dean, A. Webb Roberts Center for Continuing Medical Education of Baylor Health Care System, Dallas, Texas

 

* Corresponding author: Tel: 830-693-2220; fax 830-798-0194. Email address: vfriedew@nd.edu (V.E. Friedewald)

 

 

Introduction.

 

Among the 17,000,000 persons in the USA with coronary heart disease (CHD), about 10,000,000 have angina pectoris.1 Chronic stable angina pectoris is the primary manifestation of CHD in about one-half of patients presenting with CHD for the first time.2 Silent myocardial ischemia, defined as "objective documentation of myocardial ischemia in the absence of angina or angina equivalents" is common, occurring in 30-40% of patients with a prior acute myocardial infarction (AMI) and in about 3% of apparently healthy individuals <age 60 years and >10% of individuals age >70 years.3 Thus, stable CHD is common. The newly-diagnosed patient with CHD poses complex treatment challenges, with 3 strategic options: coronary artery bypass grafting (CABG); percutaneous coronary intervention (PCI), usually in conjunction with intracoronary stenting; and optimal medical treatment alone. In this Editor's Roundtable the faculty discusses current perspectives on these treatment  modalities in patients with stable CHD, with a focus on relevant recent clinical research and its clinical implications.

 

Objectives

 

At the conclusion of this activity the participant should be able to:

 

1. Define “stable coronary heart disease”

 

2. Prescribe optimal medical therapy for patients with stable coronary heart disease

 

3. Discriminate between patients with stable coronary heart disease who are candidates for medical therapy alone and patients who should receive coronary revascularization

 

 

 

Target Audience

 

This activity is designed for cardiologists and all other health care specialists caring for patients with acute and chronic coronary heart disease.

 

CME Credit

 

The A. Webb Roberts Center for Continuing Medical Education of Baylor Health Care System, Dallas, designates this educational activity for a maximum of l AMA PRA Category 1 Credit.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

 

The A. Webb Roberts Center for Continuing Medical Education for Baylor Health Care System, Dallas, is accredited by the Accreditation Council for Continuing Medical Education to

provide continuing medical education for physicians.

 

CME Instructions

 

After reading this article, go online at www.AJConline.org to register, complete a posttest with a minimum score of 80%, complete an evaluation and print a certificate.

Combination of Media: Print and Internet

Computer Requirements: Windows 2000, Pentium 3 or greater, 512 ram, 80 gigabytes

storage

Estimated Time to Complete: 1 hour

Release Date: November, 2011

Termination Date: November, 2012


CME Provider Contact Information:

A. Webb Roberts Center for Continuing Medical Education of Baylor Health Care System

Phone: (214) 820-2317

Email: barbarag@baylorhealth.edu


CME Provider Privacy Policy and Contact Information:

A. Webb Roberts Center for CME of Baylor Health Care System (214 -820-2317) observes privacy and confidentiality of CME information and personal information of CME participants. Third parties receive only aggregated data about CME activities that are relevant to their interests and/or the activities they support.


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