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Ask The Experts at ACC

  Center for Healthcare Education & Research

Ask the Experts ACC

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1. What was one lesson learned by the CRUSADE REGISTRY clinical trials for the treatment of unstable angina patients?
STEMI patients have higher mortality rates than found in random trials
20-30% variability in hospital care following ACC/AHA guidelines
Invasive cardiac procedures have not been accepted as part of the ACC/AHA guidelines
Excessive antithrombotic dosing reduces likelihood of bleeding



2. To help physicians determine the optimal cardiovascular safety in treatment for arthritic patients needing daily pain/anti-inflamatory treatment, the MEDAL Program disclosed that there are significant cardiovascular safety differences in the selective COX II SNAIDs and non-selective traditional NSAIDs.
True
False



3. Which ACR treatment guideline for osteoarthritis is not correct?
Options include COX II selective and traditional NSAIDs
Alternative treament choices follow the evaluation of risk factors for gastrointestinal complications, renal toxicity, and cardiovascular toxicity
Alternatives to oral therapy would include interarticular therapy with hyaluronic acid or glucocorticoids
Acetaminophen is the last line of pharmacologic intervention



4. Earlier upstream initiation of GP IIb/IIIa inhibition is associated with improved tissue perfusion on diagnostic catheterization with PCI patients.
True
False



5. Direct Factor Xa inhibitors, currently in Phase III programs, show promise in the prevention of thrombosis and appear to be as good as current standards. Oral, direct Factor Xa inhibitors include:
Fondaparinux and enoxaparin
Rivaroxaban and apixaban
Eptifibatide and apixaban
Rivaroxaban and enoxaparin



6. The FUSION II Trial on serial infusions of nesiritide concluded:
No evidence of drug-induced renal harm compared to placebo
Serial infusions of nesiritide do not result in a demonstrable clinical benefit over intensive outpatient management of patients with CDHF
Adherence to guideline-based therapy and meticulous follow-up care should be optimized for patients with CDHF
All of the above



7. Recommendations for management of patients admitted with acute decompensated heart failure (ADHF) are:
Natriuretic peptides
Inotropes
Initially, loop diuretics
Nesiritide



8. An eptifibatide dosing adjustment is required for PCI patients if their CrCl level is:
>2 mg/dL
>30 mL/min
≤50 mL/min
≤5 mg/dL