LDL-C Reduction in the High-Risk Patient: How Low Should We Go?

Title:

LDL-C Reduction in the High-Risk Patient: How Low Should We Go?

Topic: Cardiology
Relevant Terms: diabetes, lipidology, cardiovascular risk assessment, genetic studies, clinical trials
Primary Audience: Endocrinologists, Diabetologists, Diabetes Educators, Internists, Clinical Cardiologists, Geriatricians, Nurse Practitioners, Physician Assistants
Launch Date: 29-Sep-15
Credits: 1.75 AMA PRA Category 1 Credits
Expiration Date: The accreditation for this activity has expired.
Curriculum Name: How Low Can you Go?

Learning Objectives

After completing this activity, the participant will demonstrate the ability to:

  1. Appreciate the potential of PCSK9 inhibition and other therapeutic modalities to improve the management of patients with dyslipidemia
  2. Discuss how genetic evidence has revealed insights into the causality of lipids on atherogenesis
  3. Identify the major clinical issues in the management of dyslipidemia in patients with diabetes and others at high risk for CVD
  4. Recognize major benefits and limitations of statin and other add-on therapies to modulate LDL-C in reaching target goals

    Faculty

    Yehuda Handelsman, MD, FACP, FACE, FNLA
    Medical Director & Principal Investigator
    Metabolic Institute of America
    President, American College of Endocrinology
    Tarzana, CA
    Robert H. Eckel, MD
    Professor of Medicine, Physiology & Biophysics
    Charles A. Boettcher Endowed Chair in Atherosclerosis
    University of Colorado
    Aurora, CO
    Jorge Plutzky, MD, FACC
    Associate Professor
    Harvard Medical School
    Director, Vascular Disease Prevention Program
    Brigham and Women's Hospital
    Boston, MA
    Date of Original Release: May 13, 2015 (satellite symposium)

     
    This activity is provided by the American Association of Clinical Endocrinologists.
     
     
    Program management services provided by Medtelligence.
     
    This activity is supported by an educational grant from Sanofi US and Regeneron Pharmaceuticals.
     
    Needs Assessment
    The major cause of death and complications in patients with type 2 diabetes is due to cardiovascular disease (CVD). More than 60% of all patients with type 2 diabetes die of CVD, and a greater percentage will have major adverse cardiovascular events. Dyslipidemia, one of the major risk factors associated with atherosclerotic CVD, is highly prevalent in type 2 diabetes, and, along with genetic abnormalities of LDL-C such as familial hypercholesterolemia, constitutes a key target for aggressive therapy. Statins are highly effective in lowering LDL-C levels and represent first-line treatment for prevention of CVD. For nearly two decades, statin use has been a cornerstone of CVD management. The 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults essentially codified the use of statin therapy in patients at risk for cardiovascular events and stroke. Other guidelines have also endorsed the use of statins as first-line therapy, but continue to use quantitative lipid targets as treatment goals. However, despite these recommendations increasing the pool of eligible patients, many will either not take statins due to off-target effects or require intensification of therapy to avoid residual CVD risk. This requires clinicians to examine the latest data on lipid reduction and potential changes in risk reduction strategies, particularly for those at high risk of CVD and its adverse sequella.
     
    Method of Participation/How to Obtain CME Credit
    • Watch/read the educational material
    • Complete the post-test and earn a passing grade of 70% or higher to receive credit
    • Complete the activity evaluation to receive CME certificate
    Accreditation Statement
    The American Association of Clinical Endocrinologists (AACE) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
     
    The American Association of Clinical Endocrinologists (AACE) designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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    For questions regarding this CME activity, please contact:
    AACE c/o Elisabeth Ball
    Phone: (904) 353-7878
    Email: eball@aace.com
     
    Copyright
    Copyright 2015, AACE. All rights reserved. No part of this enduring material may be reproduced or transmitted in any other form or by any other means, electronic or mechanical, without first obtaining written permission from AACE.
     
    LEARNER BILL OF RIGHTS
    The American Association of Clinical Endocrinologists (AACE) recognizes that you are a life-long learner who has chosen to engage in continuing medical education to identify or fill a gap in knowledge, skill or performance. As part of AACE’s duty to you as a learner, you have the right to expect that your continuing medical education experience with AACE includes:
     
    CONTENT that:
    • Promotes improvements or quality in healthcare;
    • Is valid, reliable and accurate;
    • Offers balanced presentations that are free of commercial bias for or against a product/service;
    • Is vetted through a process that resolves any conflicts of interests of planners, teachers or authors;
    • Is driven and based on learning needs, not commercial interests;
    • Addresses the stated objectives or purpose; and
    • Is evaluated for its effectiveness in meeting the identified educational need.
    A LEARNING ENVIRONMENT that:
    • Supports learners’ ability to meet their individual needs;
    • Respects and attends to any special needs of the learners;
    • Respects the diversity of groups of learners; and
    • Is free of promotional, commercial and/or sales activities.
    DISCLOSURE of:
    • Relevant financial relationships planners, teachers and authors have with commercial interests related to the content of the activity; and
    • Commercial support (funding or in-kind resources) of the activity.
    Disclosure Information
    Declaration of Disclosure and Conflicts of Interest
    It is the policy of AACE to ensure balance, independence, objectivity and scientific rigor in all of its CME activities. Presentation content may include discussion of an unlabeled or an investigational use of a product. AACE requires that participating faculty disclose to the audience any product(s) and its use(s) discussed in the educational activity that are unapproved/unlabeled for the use by the FDA or still considered investigational in nature. 
     
    Everyone who is in a position to control the content of an educational activity must disclose all relevant financial relationships. “Relevant financial relationships” are financial relationships in any amount occurring within the past 12 months that create a conflict of interest. AACE requires speakers, faculty, CME Committee and other individuals who are in a position to control the content of this educational activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly evaluated by AACE for fair balance, scientific objectivity of studies mentioned in the presentation and educational materials used as basis for content, and appropriateness of patient care recommendations. 
     
    The intent of this disclosure is not to prevent a speaker with commercial affiliations from presenting, but rather to provide learners with information from which they may make their own judgments. Informed learners are the final safeguards in assuring that a CME activity is independent from commercial influence. 
     
    AACE has reviewed all disclosures and resolved or managed all identified conflicts of interest for this educational activity, as applicable.
     
    CME Accreditation Committee Disclosures
    Dr. Myriam Allende-Vigo reports that she has received speaker honoraria from AbbVie, Inc. and Janssen Pharmaceuticals, Inc.; and consultant honoraria from Merck & Co., Inc.
     
    Dr. Felice A. Caldarella reports that he has received speaker honoraria from Novo Nordisk A/S, Salix Pharmaceuticals, Inc. and Takeda Pharmaceutical Co. Ltd.
     
    Dr. Ricardo Correa reports that he does not have any relevant financial relationships with any commercial interests.
     
    Dr. Stephen R. Crespin reports that he does not have any relevant financial relationships with any commercial interests.
     
    Faculty Disclosures
    Dr. Yehuda Handelsman reports that he has received research grant support, consultant honoraria, and fees from Boehringer Ingelheim GmbH, GlaxoSmithKline plc, and  Novo Nordisk A/S; research grant support and consulting fees from Amgen Inc., Gilead, Merck & Co., and sanofi-aventis U.S. LLC; research grant support from Intarcia, Lexicon, and Takeda Pharmaceutical Company Limited; consultant/speaker fees from Amarin Corp., Amylin Pharmaceuticals, Janssen Global Services, LLC, and Vivus Inc; and consultant fees from Halozyme Therapeutics. He also reports that his presentation will not include discussion of any investigational or unlabeled use(s) of a product. Dr. Handelsman has an identified conflict of interest and it has been resolved accordingly. He has been advised by the AACE CME Accreditation Committee to base his presentation and recommendations on the best available, preferably published evidence/information.
     
    Dr. Robert Eckel reports that he has received scientific advisor consultant fees from sanofi, scientific consultant fees from Regeneron and Isis Pharmaceuticals, Inc., and research laboratory grant support from Esperion Therapeutics, Inc. He also reports that his presentation will not include discussion of any investigational or unlabeled use(s) of a product. Dr. Eckel has an identified conflict of interest and it has been resolved accordingly. He has been advised by the AACE CME Accreditation Committee to base his presentation and recommendations on the best available, preferably published evidence/information.
     
    Dr. Jorge Plutzky reports that he has received consultant fees from Amylin Pharmaceuticals, Inc., AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo Company, Limited, Eli Lilly and Company, Ember, F. Hoffman-La Roche Ltd/Genentech, Inc., GlaxoSmithKline plc, Merck & Co., Novo Nordisk A/S, Pfizer Inc., Takeda Pharmaceutical Company Limited, and Vivus Inc. He also reports that his presentation will not include discussion of any investigational or unlabeled use(s) of a product. Dr. Plutzky has an identified conflict of interest and it has been resolved accordingly. He has been advised by the AACE CME Accreditation Committee to base his presentation and recommendations on the best available, preferably published evidence/information.