This activity is provided by

the Discovery Institute of

Medical Education.

 

This activity is supported by an educational grant from the

Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership.

Bristol Meyers Squibb Logo

 

 

The Discovery Institute of Medical Education designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Please note that the course is accredited only for physicians (MD, DO, or equivalent). All other participants receive a certificate of completion.

In accordance with the Discovery Institute of Medical Education policies regarding financial and off-label disclosures, participants are advised that this CME activity may contain references to off-label or unapproved uses of drugs or devices. Participants should note that the use of these agents outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

© 2006-2007 Discovery Institute of Medical Education

Target Audience

This activity is designed to meet the educational needs of internists, primary care physicians, and other health care professionals with an interest in peripheral arterial disease (PAD).

Release Date

May 22, 2006

Expiration Date

May 22, 2007

Term of Offering

This activity has a release date of May 22, 2006, and is valid for 1 year. Requests for credit must be received no later than May 22, 2007. Upon successful completion of the course test, participants will receive further instruction regarding instantaneous online receipt of credit. For inquiries regarding technical issues with CME/CE or registration, email eMedicine at CME/CE Support. Please direct CME content-related questions to DIME at 312-553-8000 or dimeinfo@dimeded.org.

Estimated Completion Time

1 hour

Chair

Alan T. Hirsch, MD

Associate Professor
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Director, Vascular Medicine Program
Minneapolis Heart Institute–Abbott Northwestern's Vascular Center
Minneapolis, Minnesota

Faculty

Aaron R. Folsom, MD, MPH
Professor
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Minneapolis, Minnesota

Keattiyoat Wattanakit, MD, MPH
Clinical Instructor in Medicine (Hospitalist)
Department of Family Medicine and Community Health
University of Minnesota
Research Associate
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Minneapolis, Minnesota

Activity Purpose

The Atherosclerosis Risk in Communities (ARIC) study has collected many important new findings relative to PAD, including (but not limited to) the rate of development of PAD in individuals with diabetes, the effect of depression and psychosocial variables on development of PAD, and the rate of development of PAD in individuals with chronic kidney disease.

Despite these key findings, the clinical community is relatively unaware of the ARIC data, and the epidemiological community is unaware of how to create accessible slides for CME or clinical audience presentation. This CME activity is designed to address these problems.

Statement of Need

Patients with PAD have a 15-fold greater risk of death due to cardiovascular causes than patients without evidence of PAD. In fact, PAD may serve as a marker for myocardial infarction and ischemic stroke. PAD is caused by atherosclerotic buildup in peripheral arteries, limiting blood flow to the lower extremities. The clinical symptom is intermittent claudication characterized by pain, aches, or fatigue in leg muscles upon ambulation. This pain does not occur in resting muscles.

Although prevalence estimates vary depending on the definition used, PAD is underdiagnosed, and a significant number of patients with asymptomatic PAD are at risk for complications. Furthermore, only a small percentage of patients with PAD receive any treatment. Risk factor reduction (ie, smoking cessation, exercise, diet) and antiplatelet therapies, such as aspirin and/or clopidogrel, are the key components of treatment.

Learning Objectives

Upon completion of this activity, participants should be able to

  • understand the role of epidemiologic research in defining the incidence, prevalence, and risk factors for atherosclerotic disease;
  • identify risk factors associated with peripheral arterial disease (PAD) in a community-derived population;
  • understand the risk of cardiovascular ischemic events and mortality in individuals with PAD; and
  • understand the role of risk factors for PAD in specific “at risk” populations (eg, individuals with diabetes, chronic kidney disease).

Accreditation Statement

The Discovery Institute of Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

The Discovery Institute of Medical Education designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Faculty Disclosures

The Discovery Institute of Medical Education requires that those involved with content development and/or presentation disclose to participants any significant financial interest or other relationship (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity.

This CME activity may include discussions regarding the use of medications that may be outside of the approved labeling for these products. Physicians should consult the current prescribing information for these products. The Discovery Institute of Medical Education requires faculty members to disclose that a product is not labeled for the use under discussion. Compliance is documentation that demonstrates the provider has a practice in place to make this requirement known to the faculty.

Aaron R. Folsom, MD, MPH
Sources of Funding for Research: None.
Consulting Agreements: None.
Speakers Bureau/Honorarium Agreements: None.
Financial Interests/Stock Ownership: None.
Discussion of Off-label, Investigational, or Experimental Drug Use: None.

Alan T. Hirsch, MD
Sources of Funding for Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership, PreMD Inc., sanofi-aventis Group, SonoSite Inc.
Consulting Agreements: BioMedix, Inc.; Kos Pharmaceuticals, Inc.; SonoSite Inc.; Vasogen Inc.
Speakers Bureau/Honorarium Agreements: Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership.
Financial Interests/Stock Ownership: None.
Discussion of Off-label, Investigational, or Experimental Drug Use: None.

Keattiyoat Wattanakit, MD, MPH
Sources of Funding for Research: None.
Consulting Agreements: None.
Speakers Bureau/Honorarium Agreements: None.
Financial Interests/Stock Ownership: None.
Discussion of Off-label, Investigational, or Experimental Drug Use: None.

Instructions to Participants

Course participants must view the slide presentations and complete both a test and a course evaluation to receive continuing medical education credit. No fees are charged to participate in the program or to receive the certificate. Full instructions are available on the user instructions page.

Disclaimer

The opinions expressed herein are those of the faculty and do not necessarily represent the views of the sponsors, commercial supporters, or publisher. Please review complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Medicine is a constantly changing science, and clearly established therapies are not always available for every condition. New research findings necessitate continual changes in drug and treatment therapies. Reasonable efforts have been made to provide up-to-date, accurate information that is within generally accepted medical standards at the time of publication. However, as medical science is ever evolving, and human error is always possible, the provider, commercial supporters, and publisher (or any other involved party) do not guarantee total accuracy or comprehensiveness of the information in this article, and they are not responsible for omissions or errors or the results of using information provided in this course. Participants should confirm the accuracy of the information in this activity from other sources. In particular, all drug doses, indications, and contraindications should be confirmed in package inserts.

Click here to view minimum system requirements.