Continuing Medical Education (CME)

Secondary Prevention of Coronary Artery Disease

Introduction to this self-study CME activity

Purpose

More than 15 million people in the United States have coronary artery disease (CAD) and heart disease is the leading cause of death in the United States (217 deaths/100,000 population annually).  Patients with CAD and other vascular disease are at appreciably higher risk for subsequent cardiac events and mortality.  Several treatments and lifestyle changes for patients with CAD and other vascular disease have demonstrated large absolute risk reductions.  However, a number of studies have shown that effective secondary prevention does not occur for many patients and that only some aspects of secondary prevention are performed for many other patients. 

This guideline provides a more comprehensive approach for secondary prevention of CAD and other vascular disease.  It summarizes secondary prevention recommendations general order of descending relative risk reduction:

Smoking cessation	Pain control (caution with NSAIDs)
Antiplatelet agents & anticoagulants	Depression screening
Blood pressure control	Physical activity
Lipid management	Weight management
ß blockers	Nutrition
Renin-angiotensin-aldosterone system blockers	Immunization
Diabetes management	Supplements

The key aspects of each prevention recommendation are summarized, operational information provided, and references provided to more detailed sources of information.  The summary and elaboration will help health care professionals provide high quality care by assuring that secondary prevention is comprehensive and that highest risk conditions are priorities for management.

Audience

This self-study activity is appropriate for primary care clinicians and other health care providers who provide care for patients with CAD and other vascular disease.

Authors

Team Leader
	Denise Campbell-Scherer, MD, PhD Family Medicine
Team Members
	R Van Harrison, PhD Medical Education Robert V. Hogikyan, MD, MPH Geriatric Medicine Mark J. Lowell, MD Emergency Medicine Thomas P. O’Connor, MD General Medicine Brahmajee K. Nallamothu, MD Cardiovascular Medicine
Author Disclosures
	Team Member Company Relationship Denise Campbell-Scherer, MD, PhD None   R. Van Harrison, PhD None   Robert V. Hogikyan, MD, MPH Pfizer Shareholder Mark J. Lowell, MD None   Thomas P. O’Connor, MD None   Brahmajee K. Nallamouth, MD None

Other Acknowledgements

UMHS Guidelines Oversight Team: William E. Chavey, MD R. Van Harrison, PhD Connie J. Standiford, MD Literature search services: Taubman Medical Library Production of Internet format and web site maintenance: Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was prepared for release in March 2009.  Credit may be awarded for a maximum of three years from its release date, specifically from March 2009 through February 2012.  Continuation of credit from that date depends on a thorough review of the content currency and accuracy.

Method of Participation

1. View the web pages. You may print the self-study text to read off-line.
2. Complete the on-line learning assessment test with a score of 70% or higher.  After you initially take the test, the test will be immediately electronically scored. 
   If fewer than 70% of the questions are answered correctly, the questions that were not answered correctly will be noted in red.  Review the CME content related to those topics and retake the test.
   If 70% or more of the questions are answered correctly, the correct and incorrect answers for all questions will be shown along with explanations of the basis for the correct answer.  The link to register and receive credit is shown at the end of the items and explanations. 
3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
4. Print the certificate of participation for your personal records.

 

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