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Nursing Challenges in the Management of Acute Coronary Syndrome: <br>A Clinical Curriculum on Antiplatelet Therapies

Nursing Challenges in the Management of Acute Coronary Syndrome:
A Clinical Curriculum on Antiplatelet Therapies


Clinical Review

Time to Complete

2 Hours


February 1, 2009


January 13, 2011

Program Description

Each year, more than 2 million patients in the United States suffer from acute coronary syndrome (ACS). The National Institute of Medicine has identified the prevention and reduction of recurring ischemic events and optimization of individual functioning as key elements of quality improvement. Health-care professionals, particularly RNs and NPs, play a key role in preventing catastrophic ischemic events by recognizing patients at increased risk for stent thrombosis, providing appropriate treatment and prevention plans, and ensuring that they are compliant with antiplatelet therapy for at least 1 year after stent placement. The familiarity of RNs and NPs with their patients, as well as current evidence-guided management recommendations, can improve clinical outcomes for patients with ACS, emphasizing the importance of up-to-date education for RNs and NPs, both during and following an acute ischemic event.

Educational Objectives

After taking part in this educational activity, participants should be better able to:
  • Explain current approaches to antiplatelet therapy for patients with acute coronary syndrome, particularly those undergoing percutaneous coronary intervention (PCI).
  • Summarize the latest American College of Cardiology/American Heart Association/Societyfor Cardiovascular Angiography and Interventions guidelines on the continuation of antiplatelet therapy following PCI.
  • Educate patients on the importance of antiplatelet therapy, discuss the morbidity and mortality risks and costs of premature discontinuation of antiplatelet therapy, and devise methods to ensure compliance with treatment.
  • Outline the benefits and limitations of current approaches to antiplatelet therapy, focusing on the post-PCI period, and describe patient risk factors associated with late in-stent thrombosis.
  • List new antiplatelet agents in development and the essential attributes (site and mechanism of action; pharmacokinetic profile; clinical trials data on safety, efficacy, and outcomes) that distinguish them from current therapies.


It is the policy of Montefiore Medical Center to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty participating in our programs are expected to disclose any relationships they may have with commercial companies whose products or services may be mentioned, so that participants may evaluate the objectivity of the presentations. In addition, any discussion of off-label, experimental, or investigational use of drugs or devices will be disclosed by the faculty.

Deepak L. Bhatt, MD, MPH, FACC, FSCAI, FESC, FACP, FAHA, receives research grants (directly to Institution) from Bristol-Myers Squibb, Eisai, Ethicon, Heartscape, sanofi-aventis, and The Medicines Company. He is a consultant and on the advisory board of Arena Pharmaceuticals, Astellas Pharma, AstraZeneca, Bayer Pharmaceuticals, Bristol-Myers Squibb, Cardax Pharmaceuticals, Centocor, Cogentus Pharmaceuticals, Daiichi-Sankyo, Eisai, Eli Lilly and Company, GlaxoSmithKline, Johnson & Johnson, Ortho-McNeil, Medtronic, Millennium Pharmaceuticals, Molecular Insight Pharmaceuticals, Otsuka, ParinGenix, PDL BioPharma, Philips, Portola Pharmaceuticals, sanofi-aventis, Schering-Plough Corporation, Scios, Takeda Pharmaceuticals, The Medicines Company, and Vertex Pharmaceuticals. Dr. Bhatt has donated consultant/advisory fees to nonprofits for over 2 years.

Eileen M. Handberg, PhD, ARNP, BC, FAHA, receives unrestricted educational grant support by way of the University of Florida from AstraZeneca, Boehringer Ingelheim, CV Therapeutics, Daiichi-Sankyo Lilly, Merck & Co., Pfizer Inc, sanofi-aventis, and Schering-Plough Corporation for the Vascular Biology Working Group.

Susan D. Housholder-Hughes, RN, MSN, CCRN, ANPBC, ACNS-BC, FAHA, receives honoraria and is on the speakers’ bureau of Schering-Plough Corporation.

Anne Marie Palatnik, MSN, APN, BC, receives honoraria and is on the speakers’ bureaus of sanofi-aventis, Schering-Plough Corporation, and The Medicines Company.

This CE activity does contain information about off-label/unapproved uses of drugs. Please be sure to read full prescribing information on the agents mentioned in this program prior to using for patient care.

This program is sponsored by Montefiore Medical Center.

This program is supported by an educational grant from Daiichi-Sankyo Lilly.


Chief of Cardiology, VA Boston Healthcare System
Director, Integrated Interventional Cardiovascular Program
Brigham and Women’s Hospital and the VA Boston
Healthcare System
Boston, MA

Eileen M. Handberg, PhD, ARNP, BC, FAHA
Research Associate Professor of Medicine
Director, Clinical Programs
Division of Cardiovascular Medicine
University of Florida College of Medicine
Gainesville, FL

Susan D. Housholder-Hughes, RN, MSN, CCRN, ANP-BC, ACNS-BC, FAHA
Nurse Practitioner
Department of Internal Medicine
Division of Cardiovascular Medicine
University of Michigan Health System
Ann Arbor, MI

Anne Marie Palatnik, MSN, APN, BC
Director of Clinical Learning
Center for Learning
Virtua Health
Marlton, NJ




CE for Nurses

Accreditation Statement

Montefiore Medical Center, Division of Education & Organizational Development, is an approved provider of continuing nursing education by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

Designation Statement

This activity is awarded 2 contact hours.


To obtain credit, a score of 70% or better is required. This CME is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the posttest survey, and have received your digital copy of your credit certificate. Your online certificate will be saved on within your Profile/Exam History, which you can then access at any time.


Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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