Overview

The epidemiology of acute coronary syndromes has changed dramatically in the past few decades, with lower overall incidence of myocardial infarction (MI) -- particularly ST elevation MI -- and improved survival after an incident MI. The diagnosis and classification of MI is challenging, particularly in the era of sensitive troponin assays. Clinicians must be aware of the frequent occurrence and causes of troponin elevations from conditions other than MI. Following diagnosis, risk stratification for patients with non-ST elevation ACS is critical to making prudent decisions and selecting among the multitude of different options for invasive and medical therapies. When considering potent antiplatelet and antithrombotic therapies, it is of paramount importance to also consider bleeding risk. Primary care clinicians play a critical role in determining the optimal duration of dual antiplatelet therapy, ensuring appropriate use and adherence to evidence-based medical therapies, and addressing lifestyle factors that can help prevent or modify the course after an ACS event. 

Learning Objectives

  • Discuss the evolving epidemiology of ACS and the important contributions from primary care physicians
  • Appropriately diagnose and sub-classify MI using troponin tests and clinical parameters
  • Incorporate simple risk stratification schemes into the evaluation and management of ACS
  • Appropriately balance risk and benefit from potent antiplatelet therapies 


CME/CE Information

AMA PRA Category 1 Credits

Accreditation Statement

pmiCME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Designation Statement

pmiCME designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For APRNs and PAs, AANPCB and NCCPA accept AMA PRA Category 1 Creditâ„¢ as the number of hours of participation (AANPCB) or as Category 1 CME credits (NCCPA).

Faculty Disclosures

The following financial relationships have been disclosed by faculty.

James A. de Lemos, MD

Advisory Board for Amgen and Novo Nordisk Inc. 

Disclosures

The following financial relationships have been disclosed by faculty.

Commercial Supporter

Not Applicable 

Education Partner

Not Applicable


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