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This course requires Windows Operating Systems (95/98, NT, 2000, ME, XP), version 5.5 browsers or higher from Microsoft or Netscape.

Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Macromedia Flash, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, and Real Networks Real One Player.

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 the Elsevier Office of Continuing Medical Education (EOCME) and Excerpta Medica Inc. The EOCME is accredited by the ACCME to provide continuing medical education (CME) for physicians.

CREDIT DESIGNATION STATEMENT

The EOCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

DISCLOSURES

As a sponsor accredited by the ACCME, it is the policy of the EOCME to require the disclosure of anyone who is in a position to control the content of an educational activity. All relevant financial relationships with any commercial interests and/or manufacturers must be disclosed to participants at the beginning of each activity. The faculty of this CME activity disclose the following:

RESOLUTION OF CONFLICT OF INTEREST

The EOCME has implemented a process to resolve conflicts of interest for each CME activity. In order to help ensure content objectivity, independence, fair balance, and that the content is aligned with the interest of the public, the EOCME has resolved the conflict by conducting peer review.

UNAPPROVED/OFF-LABEL USE DISCLOSURE

The EOCME requires CME faculty to disclose to the participants:

1. When products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not US Food and Drug Administration [FDA] approved); and

2. Any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.

Faculty may discuss information about pharmaceutical agents that is outside of FDA-approved labeling. This information is intended solely for CME and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

INTENDED AUDIENCE

This activity has been developed for cardiologists, interventional cardiologists, pulmonologists, and emergency medicine physicians.

PROGRAM GOALS

Fibrinolysis is the most widely used reperfusion strategy for patients with ST-elevation myocardial infarction (STEMI). As new anticoagulant agents become available, clinicians need to be aware of their benefits and limitations and their recommended place in therapy. The goals of this program are to provide a comprehensive review of recent trials of anticoagulant agents in STEMI patients undergoing fibrinolysis and discuss current guideline recommendations for their use.

EDUCATIONAL OBJECTIVES

• Discuss thrombolytic therapy for myocardial infarction with fibrinolytic agents 
• Explain the 2007 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for patients receiving fibrin-specific agents, as well as those receiving streptokinase who are at high risk for thromboembolic events
• Compare direct thrombin inhibitors, factor Xa inhibitors, unfractionated heparin (UFH), and low-molecular-weight heparins (LMWHs) as adjunctive therapy to fibrinolysis
• Explain the overall importance of this clinical initiative

FINANCIAL SUPPORT

This CME activity is supported by an educational grant from sanofi-aventis U.S.

CME PLANNING COMMITTEE

CME INQUIRIES

For all CME certificate inquiries, please contact Sandy Bakos at s.bakos@elsevier.com

SPECIAL NEEDS