Target Audience (click to view)
This activity is designed to meet the needs of physicians and nurses.
Learning Objectives(click to view)
Upon completion of the educational activity, participants should be able to:
- Discuss the key findings of six studies presented at the 2017 annual scientific sessions of the American College of Cardiology.
Method of Participation(click to view)
Release Date: 6/12/2017
Expiration Date: 6/12/2018
Statements of credit will be awarded based on the participant reviewing monograph, correctly answer 2 out of 3 questions on the post test, completing and submitting an activity evaluation. A statement of credit will be available upon completion of an online evaluation/claimed credit form at intivahealth.akhcme.com/procial/lessons/12. You must participate in the entire activity to receive credit. If you have questions about this CME/CE activity, please contact AKH Inc. email@example.com.
Credit Available(click to view)
CME Credit Provided by AKH Inc., Advancing Knowledge in Healthcare
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 providership of AKH Inc., Advancing Knowledge in Healthcare and Physician’s Weekly’s. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.
AKH Inc., Advancing Knowledge in Healthcare designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME.
AKH Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
This activity is awarded 0.5 contact hours.
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It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author 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 conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Author Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other author for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.
Disclosure of Unlabeled Use & Investigational Product(click to view)
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer(click to view)
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant’s misunderstanding of the content.
Faculty & Credentials(click to view)
Complete the Post Test(click to view)
New research was presented at ACC 2017, the American College of Cardiology’s Scientific Sessions, from March 10th to the 12th in Orlando. The features below highlight some of the studies presented at the conference.
Radiation Dose by PCI Approach
Research has shown that radial access for PCI, when compared with femoral access, is associated with lower risks of bleeding, vascular complications. Survival rates have also been higher for patients with acute coronary syndrome who receive radial access PCI. Despite this data, experts suspect that radial access increases radiation exposure for both patients and operators. For a study, researchers examined radiation exposure among 18 operators who performed more than 700 PCI procedures. The operator equivalent dose at the thorax was 77 µSv with radial access, compared with a dose of 41 µSv with femoral access at 77, representing a significant difference. The authors noted that fluoroscopy time was 10 minutes with radial access and 9 minutes with femoral access.
Troponin T Levels Signal Post-Op Heart Damage
Few studies have explored whether testing for troponin T levels in the blood may help identify patients with heart damage after non-cardiac surgery who may require prompt life-saving treatment. Using a high-sensitivity troponin T test, study investigators recorded blood levels of the protein prior to and after surgery among more than 21,000 patients. They also looked at rates of major post-surgical complications. Patients with troponin T levels of 20 ng/L to 64 ng/L after surgery had a 3.0% overall risk of death, compared with a 0.1% risk that was observed among those with a peak troponin T level of 5 ng/L. About 18.0% of patients experienced a heart injury, and 93.0% of these injuries would have been missed without monitoring troponin levels.
Exercise for Hypertrophic Cardiomyopathy
Patients with hypertrophic cardiomyopathy are often instructed to follow conservative physical-activity restrictions due to a lack of randomized trials to help inform treatment decisions. For a study, patients with hypertrophic cardiomyopathy were randomized to a 4-month moderate-intensity exercise-training program or were told to partake in their usual exercise habits. The intervention was structured but unsupervised. Patients randomized to moderate-intensity exercise—such as brisk walking 4 to 7 days per week for a minimum of 30 minutes—experienced a small but significant increase in exercise capacity when compared with the usual exercise group. Moderate exercise did not trigger ventricular arrhythmia, sudden cardiac arrest, or appropriate defibrillator shock. No mortalities were recorded among participants.
Reducing Stroke Risk From AF
Use of procedures to close the left atrial appendage at the time of cardiac surgery in patients with atrial fibrillation (AF) varies widely due to a lack of research supporting the safety and efficacy of such procedures. To address this research gap, a study team analyzed the health records of Medicare patients with AF who underwent CABG, aortic valve surgery, or mitral valve surgery in 2011 or 2012. Among those who had their left atrial appendage closed during their surgery as an add-on procedure, 1.6% were hospitalized for thromboembolism within 12 months. In comparison, 2.5% of those who did not undergo the add-on procedure experienced thromboembolism during this period. Closing the left atrial appendage was also associated with a 15.0% reduction in mortality rate and a 21.0% reduction in the composite endpoint of thromboembolism, hemorrhagic stroke, and death.
Closed Loop Stimulation & Syncope
Small studies of closed loop stimulation—a pacing program designed to detect and stop the abnormal heart rhythms that precede syncope in patients with a pacemaker—have had varying results. Study investigators conducted a prospective double-blind placebo-controlled trial to determine if closed loop stimulation (DDD-CLS) can significantly reduce syncope when compared with a pacing program that does not respond to the contractions in the heart that precede syncope (DDI). Participants had experienced at least five syncope episodes during their life, including more than two in the past year. Four patients experienced syncope while receiving DDD-CLS, compared with 21 patients who fainted during DDI pacing.
Web-Based Lifestyle Counseling for High BP
Data are lacking on the effects of online behavioral interventions that aim to help patients reduce high blood pressure (BP). For a study, older adults with an average baseline BP of 140/90 mm Hg were randomized to e-counseling or a control group. Both groups received emails weekly for 4 months, every other week for another 4 months, and monthly for an additional 4 months. Emails for the e-counseling group provided links to online multimedia and interactive tools to increase motivation and skills and to sustain a heart-healthy lifestyle. Emails to the control group linked to generic information about heart-healthy living and reducing high BP. Patients in the e-counseling group experienced a reduction in systolic BP of 10.0 mm Hg, compared with a reduction of just 6.0 mm Hg among those in the control group. The e-counseling group also had an average reduction of 4.0 mm Hg in pulse pressure, compared with an average reduction of 1.5 mm Hg in the control group.
NEWS FROM ACC 2017