- Dual Antiplatelet Therapy for Acute Stroke and TIA: Current Best Practice and Emerging Strategies
Dual Antiplatelet Therapy for Acute Stroke and TIA: Current Best Practice and Emerging Strategies
- Heart Failure
Course Published On:
Course Expiry Date:
In the days and weeks following a minor stroke or transient ischaemic attack (TIA), patients are at increased risk for a secondary stroke. Secondary strokes are common and are often more disabling and more likely to be fatal than the index event. Patients are at the greatest risk for a secondary stroke in the 30 days following an acute event, with an estimated 5.2% of patients experiencing a recurrent ischaemic stroke in the first 7 days after an index event. Clinical studies have demonstrated that the acute treatment of ischaemic stroke or TIA should include antiplatelet therapy within 24 hours of an index event with dual antiplatelet therapy (DAPT; aspirin + clopidogrel) recommended for 21 days after an event. While the benefit of DAPT for reducing thrombotic risk after a stroke has been established, findings from recent studies suggest that alternative agents and durations of treatment following and acute minor ischaemic stroke or TIA may further reduce the risk of secondary stroke and improve outcomes for patients. Such data also highlight the need for a personalized approach to secondary stroke prevention which takes account of individual risk factors in terms of underlying causation, health status and bleeding risk. Increased awareness among physicians of these recent developments and strategies to assess early stroke risk and use this information to guide the choice of therapy is necessary to implement these findings in clinical practice.
In compliance with EBAC / EACCME guidelines, all speakers/chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations.
The Organising Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.
This programme is supported by an unrestricted educational grant from AstraZeneca. The scientific programme has not been influenced in any way by the sponsor.
Terms & Conditions
Radcliffe Education requires contributors to our CME programmes to disclose any relevant financial relationships that have occurred within the past 12 months that could create a conflict of interest. These will be identified in the faculty section if applicable.
This session ‘Dual antiplatelet therapy for acute stroke and TIA: Current best practice and emerging strategies’ is accredited by the European Board for Accreditation in Cardiology (EBAC) for 1 hour of external CME credits.
Each participant should claim only those hours of credit that have actually been spent in the educational activity. EBAC works according to the quality standards of the European Accreditation Council for Continuing Medical Education (EACCME), which is an institution of the European Union of Medical Specialists (UEMS).
Through an agreement between the European Board for Accreditation in Cardiology and the American Medical Association, physicians may convert EBAC External CME credits to AMA PRA Category 1 Credits™. Information on the process to convert EBAC credit to AMA credit can be found on the AMA website.
Instructions to Participants
There is no fee for taking part in this online learning activity.
Activities are designed to be completed within 60 minutes and must be completed by the registered user. Physicians should only claim credits for time spent on the activity. To successfully earn credit, participants must complete the activity in full in the indicated time frame.
To complete the course and claim certification participants must:
- Read the course outline information supplied and complete pre-test questions if supplied prior to starting the activity. Users must read and study the activity in its entirety before completing the post-test questions.
- Your results will be automatically saved and if a pass score is achieved (where applicable), you may be eligible to claim credit for the activity and receive a certificate of completion.
- To highlight the continued high unmet need for strategies to prevent stroke or death for patients experiencing acute stroke or TIA
- To outline the guidelines on the use of dual antiplatelet therapy for patients presenting with acute stroke or TIA
- To examine recent evidence from clinical trials on novel strategies for improving outcomes for patients presenting with acute stroke or TIA and how these data and insights can be applied in clinical practice
|1||Chairperson’s welcome and introduction||Pierre Amarenco (Paris University, FR)|
|2||Secondary prevention following acute minor stroke or TIA: Understanding the ongoing risk||Peter Rothwell (University of Oxford, UK)|
|3||Current best practice: Evidence-based antiplatelet therapy for secondary stroke prevention||Pierre Amarenco (Paris University, FR)|
|4||Evolving role of dual antiplatelet therapy for stroke prevention: Advancing best practice for patients at high risk||Clay Johnston (The University of Texas, Austin, US)|
|5||Clinical decision making for the patient presenting with acute stroke||Peter Schellinger (Universitatslinikum Der Ruhr-Universitat Bochum, DE)|
|6||Faculty discussion: The use of anti-platelet therapy to manage patients following an acute stroke||Pierre Amarenco (Paris University, FR) Peter Rothwell (University of Oxford, UK) Clay Johnston (The University of Texas, Austin, US) Peter Schellinger (Universitatslinikum Der Ruhr-Universitat Bochum, DE)|
Chairperson’s welcome and introduction
Secondary prevention following acute minor stroke or TIA: Understanding the ongoing risk
Current best practice: Evidence-based antiplatelet therapy for secondary stroke prevention
Evolving role of dual antiplatelet therapy for stroke prevention: Advancing best practice for patients at high risk
Clinical decision making for the patient presenting with acute stroke
Faculty discussion: The use of anti-platelet therapy to manage patients following an acute stroke
- Not accredited
- Appraise new updates in heart failure guideline-directed medical therapy (GDMT)
- Apply latest guideline recommendations to patient cases
- Describe barriers preventing early initiation of GDMT
- Identify the roles of nurses and other healthcare professionals to achieve optimal heart failure therapy
- Identify the importance of the nurse/cross-functional team
- To differentiate ATTR phenotypes based on presenting signs and symptoms.
- To select appropriate tests to monitor symptomatic ATTR-cm from imaging, biomarker, functional and QoL assessments.
- To recall how to identify disease progression across ATTR-cm.
- To describe the different disease modifying treatments for ATTR including novel agents.
- Not accredited
- Appraise the urgency needed in rapid initiation of GDMT to improve HF outcomes.
- Recognise barriers preventing the use of GDMT in current practice.
- Identify strategies needed to drive implementation of GDMT in clinical practice.
- Not accredited
- Explain the relationship between sub-optimal RAASi therapy and poor cardio-renal outcomes
- Identify patients who would benefit from anti-hyperkalaemia medications
- Select appropriate anti-hyperkalaemia treatments across a range of patient profiles
- Adopt anti-hyperkalaemia medications as an approach to prolong optimal RAASi therapy
- Summarise current guideline recommendations on the use of potassium binding agents
- Identify individuals likely to have HFpEF from initial presentation
- Refer suspected individuals for specialist assessment
- Initiate GDMT for HF as soon as patients are stable
- Initiate GDMT in HF regardless of EF and phenotype
- Initiate shared decision-making on complex HF patients with other members of the multidisciplinary team including cardiologists, GPs, nephrologists and diabetologists
- Recall the general approach to diagnosis and stratification of HCM according to the latest guidelines and expert opinion
- Apply advanced echocardiographic methodologies to equivocal HCM diagnoses
- Select appropriate imaging modalities to facilitate accurate risk stratification
- Stratify patients based on specific risk features and disease severity
- Choose suitable treatment modalities for patients based on specific disease features and severity
- Review current GDMT in HFrEF and HFpEF
- Describe the relationship between initiation of GDMT and HF outcomes
- Prescribe GDMT according to current international recommendations
- Recall the elements of the Kansas City Cardiomyopathy Questionnaire
- Describe the clinical studies that support the use of functional and QoL measures in practice
- Initiate quality of life and functional improvement measures in routine practice
- Initiate SGLT-2 inhibitors in patients presenting with De novo HF and in patients already on other GDMT
- Adopt shared decision-making with HF patients
- Recall the utility of EF in heart failure treatment, patient selection and treatment response
- Identify alternative measures to EF for the purposes HF severity and therapeutic efficacy
- Incorporate quality of life measures for assessing therapeutic efficacy in HF
- Recall outcomes from heart failure trials from recent congress and publications and their impact on practice
- Recall the results of key trials in HFmrEF in different patients' sub-groups
- Describe how SGLT-2 inhibitors can be used across the range of LVEF
- Apply emerging diagnostic approaches for HFpEF and HFmrEF
- Implement best-practice strategies across the range of LVEF
- Not accredited
- Identify HFpEF patients who may benefit from being initiated on an SGLT-2 inhibitor
- Recall current inertia rates amongst prescribers who manage heart failure
- Adopt effective treatment strategies for HFpEF patients early in the disease course
- Recall current guideline directed medical therapy options in HFpEF
- Review clinical, real world and quality of life evidence for the use of SGLT-2 inhibitors in HFpEF