Optimizing the Appropriate Use of Pharmacologic Stress Agents in
Cardiovascular Imaging Based on Patient Profiles Web Activity

• Release date: December 30, 2010
• Expiration date: June 30, 2012
• Estimated time to complete activity: 2.50 hours
• Compatible with (IE 6 and up, Firefox, Safari)

Target Audience

This activity has been designed to meet the educational needs of clinicians involved in or with an interest in utilizing single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI or MPI).

Statement of Need/Program Overview

In order to accurately diagnose and/or characterize CAD in patients via SPECT MPI, clinicians must have extensive expertise in performing and interpreting the test. This includes knowledge of testing protocols, as well as selection of the appropriate pharmacologic stress agent for individual patients. Considering the recent developments in cardio medical imaging, including the approval of a new pharmacologic stress agent in 2008, educational intervention is necessary to keep cardiologists and associated clinicians current. Furthermore, an unmet educational need has been identified regarding cardiologists' awareness of appropriate selection of available pharmacological stress agents for different patient profiles.

Educational Objectives
After completing this activity, the participant should be better able to:

• Recognize the diagnostic advances that have occurred since the last revision of the ACC/AHA clinical competence statement on stress testing, as reflected in the more recent ASNC imaging guidelines
• Identify the cognitive skills needed to perform stress radionuclide cardiac imaging as they pertain to the supervision of vasodilator or adrenergic-stimulating agent stress
• Characterize the indications and contraindications associated with each of the 4 available pharmacologic stress agents for SPECT MPI and apply these indications/contraindications to individual patient profiles
• Describe the effectiveness of pharmacologic stress agents in special populations including COPD, renal failure, and obesity

Distinguished Faculty

Manuel D. Cerqueira, MD, FACC, FASNC, FAHA Chairman of Nuclear Medicine, Imaging Institute Staff Cardiologist, Sydell and Arnold Miller Family          Heart & Vascular Institute Cleveland Clinic Foundation Professor of Radiology and Medicine,          Cleveland Clinic Lerner College of Medicine,          Case Western Reserve University Click here for biography

John J. Mahmarian, MD, FACC, FASNC, FSCCT Professor of Medicine, Weill Cornell Medical College Director of the Nuclear Cardiology and CT Laboratories,          Methodist DeBakey Heart and Vascular Center,          The Methodist Hospital Click here for biography

Activity Agenda

• Module 1: The Rationale for Exercise or Pharmacologic Stress Testing
  • Pharmacologic Stress Testing for SPECT Myocardial Perfusion Imaging: Preferred over Exercise Stress?
    John J. Mahmarian, MD, FACC, FASNC, FSCCT
  • Pharmacologic Stress Agents: What is Available and How to Use Them
    Manuel D. Cerqueira, MD, FACC, FASNC, FAHA
• Module 2: Advances in Pharmacologic Stress Agents
  • Selective A2A Agonists for Pharmacologic Stress Testing: Mechanisms of Action and Administration
    Manuel D. Cerqueira, MD, FACC, FASNC, FAHA
  • Selective A2A Agonists: What Do Clinical Trials Tell Us?
    John J. Mahmarian, MD, FACC, FASNC, FSCCT
• Module 3: Managing Special Populations and Side Effects with Pharmacologic Stress Agents
  • A2A Agonists in Special Populations: COPD, Renal Failure and Obesity
    John J. Mahmarian, MD, FACC, FASNC, FSCCT
  • A2A Agonists Side Effects and Management: Frequency, Treatment and Use of Exercise
    Manuel D. Cerqueira, MD, FACC, FASNC, FAHA

Physician Continuing Medical Education

Accreditation Statement:
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Impact Education, LLC. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation:
Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Fee Information

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Method of Participation and Request for Credit

There are no fees for participating and receiving CME/CE credit for this activity. During the period December 30, 2010 through June 30, 2012, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) successfully complete the online post-test, with a passing score of 70% or better; 4) complete the online evaluation form. Upon successful completion of post-test and evaluation, you will have access to an immediate online certificate.

Media

Internet

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Impact Education, LLC, and Astellas Pharma US, LLC, do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, Impact Education, LLC, and Astellas Pharma US, LLC. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.