Protecting patients with CAD beyond the stent: highlighting the gap between evidence and clinical practice

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Location: Trinity Hall, Trinity College, Cambridge University, England, UK
Session 1: ##ACADEMY_DATE## BST
This meeting has been organised and paid for by AstraZeneca, in collaboration with Radcliffe Cardiology and European Cardiology Review


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This online meeting is designed for healthcare professionals involved the management and treatment pathway of ACS patients, from the hospital specialists, cardiology-related department including the Emergency services, as well as GP’s with a specific interest in cardiology.

This event will offer a scientific platform to review and discuss the duration of therapy to and beyond 12 months for ACS patients.

The presentations will focus on clinical trial and real-world evidence for the short and long-term benefits of DAPT following ACS and will review current guidelines. There will also be a discussion around disparities between evidence/recommendations and everyday practice worldwide. The meeting will also provide a forum for debate and to share experiences.

Prof Lina Badimon (Moderator)
Prof Lina Badimon is the Director of the Cardiovascular Science Institute (ICCC) in Barcelona in the Hospital Santa Creu and San Pau, Director of the Cardiovascular Research Chair of the Autonomous University of Barcelona and Director of the UNESCO Chair in Biomedical Sciences Training and Research.
Her research activities focus on thrombosis and hemostasis, atherosclerosis and ischemic heart disease. She has published over 500 articles in highly qualified scientific journals with her work highly quoted in the scientific literature and she is an Editorial Board member for various international scientific journals.


Dr Dominick Angiolillo
Dr Angiolillo joined the University of Florida College of Medicine – Jacksonville in 2004. Currently, Dr Angiolillo is a professor of medicine with tenure status. He is also the director of Cardiovascular Research, program director of the Interventional Cardiology Fellowship Program and a staff cardiologist and interventional cardiologist with the University of Florida Health System. Dr Angiolillo is board certified by the American Board of Internal Medicine in internal medicine, cardiovascular disease and interventional cardiology.


Dr Christopher Granger
Dr Granger, MD is a Professor of Medicine in the Division of Cardiology and a member of the Duke Clinical Research Institute, Duke University School of Medicine in North Carolina, USA. Dr Granger is a Fellow of the American College of Cardiology, the American Heart Association and of the European Society of Cardiology. His primary research interests are in the conduct and methodology of large randomized trials in heart disease. He is Associate Editor of the American Heart Journal and serves on the editorial board of the Journal of American College of Cardiology.


Prof Johanne Silvain
Prof Johanne Silvain is a Professor of Medicine at the University of Pierre and Marie Curie in Paris, France. He is an interventional cardiologist, with expertise in coronary angioplasty and CTO and is the Director of the Coronary Intensive Care Unit. He qualified at the University of Medicine of Paris (UPMC) and has authored over 100 publications in established and respected journals. Dr Silvain’s research interests lie in the area of thrombosis (thrombotic composition) to antithrombotic (anticoagulant and antiplatelet agents) and its consequences on bleeding and transfusion.

This online meeting aims to:

  1. Raise awareness of the high and persistent ongoing ischemic risk of CAD patients with a prior MI (Apollo Helicon, Preclude, Prospect, Epicor, Grace, Reach, Frisc)
  2. Highlight the gap between body of evidence (RCTs, RWE and guidelines recommendations/ address updates) and daily practise at 12 months (OAP choice and DoT) and beyond
  3. Understand why the gaps happen and what can be done to address those

A satellite symposium to reflect on antithrombotic strategies after coronary revascularisation, exploring safety, efficacy, and control in light of new evidence from the RE-DUAL PCI trial.

Topic Speaker
Welcome and Introductions
The gap between evidence and clinical practise
Lina Badimon
Recognition of the ongoing ischemic risk our patients face Johanne Silvain
Individualised patient approaches for DAPT; duration to 12 months Chris Granger
Individualised patient approaches for DAPT; duration beyond 12 months Dominick Angiolillo


Important Information for Healthcare Professionals:

BRILIQUE® 60MG & 90MG FILM-COATED TABLETS (ticagrelor) PRESCRIBING INFORMATION. Consult Summary of Product Characteristics before prescribing.

Use: Adults aged 18 years and older, co-administered with 75-150mg acetylsalicylic acid (ASA) daily unless specifically contraindicated: for the prevention of atherothrombotic events in patients with acute coronary syndromes (ACS); or a history of a myocardial infarction (MI) and a high risk of developing an atherothrombotic event. Presentation: 60mg or 90mg ticagrelor film-coated tablets. Dosage and administration: ACS: Treatment should be initiated with a single 180mg loading dose (two tablets of 90mg) and then continued at 90mg twice daily. Treatment with Brilique 90mg is recommended for 12 months in ACS patients unless discontinuation is clinically indicated. History of MI: 60mg twice daily for extended treatment in patients with a history of MI of at least one year and a high risk of an atherothrombotic event. Treatment may be started without interruption as continuation therapy after the initial one year treatment with Brilique 90mg or other adenosine diphosphate (ADP) receptor inhibitor therapy in ACS patients with high risk of an atherothrombotic event. Treatment can also be initiated up to 2 years from the MI, or within one year after stopping previous ADP receptor inhibitor treatment. Limited data on efficacy and safety of Brilique beyond 3 years of extended treatment. If a switch is needed, the first dose of Brilique should be administered 24 hours following the last dose of the other antiplatelet medication. Lapses in therapy should be avoided. For oral use. Brilique can also be crushed, mixed with water and either drunk or administered via a nasogastric tube. Contraindications: Hypersensitivity to the active substance or to any of the excipients. Active pathological bleeding. History of intracranial haemorrhage. Severe hepatic impairment. Co-administration with strong CYP3A4 inhibitors (e.g. ketoconazole). Precautions: Use with caution in patients at an increased risk for bleeding (e.g. recent trauma or surgery, coagulation disorders or recent gastrointestinal bleeding) or those on concomitant medication that may increase bleeding risk (e.g. NSAIDs, oral anticoagulants and/or fibrinolytics) within 24 hours of taking Brilique. Brilique should be stopped 7 days prior to elective surgery if the antiplatelet effect is not desired. In patients with a history of MI with prior ischemic stroke, treatment beyond 1 year is not recommended. Not recommended in patients on renal dialysis. Use with caution in patients with moderate hepatic impairment. Use with caution in patients with an increased risk of bradycardic events or when administered concomitantly with medicinal products known to induce bradycardia. Use with caution in patients with a history of asthma and/or COPD or a history of hyperuricaemia or gouty arthritis. Use in patients with uric acid nephropathy is discouraged. Creatinine levels may increase during treatment with Brilique, renal function should be checked according to routine medical practice and in ACS patients, one month after starting Brilique, paying special attention to patients ≥ 75 years, patients with moderate-to-severe renal impairment and those receiving concomitant treatment with an ARB. Premature discontinuation with antiplatelet therapy including Brilique could result in an increased risk of CV death or MI due to the patient's underlying disease and should therefore, be avoided. Co administration of Brilique is not recommended with a high maintenance dose of ASA (> 300mg) or with doses of simvastatin > 40mg. Co administration of ticagrelor with strong CYP3A inducers is discouraged, as this may lead to a decrease in exposure and efficacy of ticagrelor. No data are available on concomitant use of Brilique with other drugs that also are potent P-glycoprotein (P-gp) inhibitors and moderate CYP3A4 inhibitors (e.g. verapamil, quinidine) that may increase ticagrelor exposure. If the association cannot be avoided, their concomitant use should be made with caution. Caution is advised in co-administration with medicinal products that alter haemostasis or with SSRIs. Brilique is not recommended during pregnancy and breastfeeding. Patients who experience dizziness and confusion during treatment should be cautious when driving or using machines. Undesirable events: Very Common: blood disorder bleedings, hyperuricaemia, dyspnoea Common: gout/gouty arthritis, dizziness, syncope, headache, vertigo, hypotension, respiratory system bleedings, gastrointestinal haemorrhage, diarrhoea, nausea, dyspepsia, constipation, subcutaneous or dermal bleeding, rash, pruritus, urinary tract bleeding, blood creatinine increased, post procedural haemorrhage and traumatic bleedings. Uncommon: tumour bleedings, hypersensitivity including angioedema, confusion, intracranial haemorrhage, eye haemorrhage, ear haemorrhage, retroperitoneal haemorrhage, muscular bleedings and reproductive system bleedings. Consult SmPC for a full list of adverse events.

Legal category: POM. Marketing authorisation number: 60mg – EU/1/10/655/008 and 90mg – EU/1/10/655/004. Basic NHS cost: Brilique 60mg film-coated tablets 56: £54.60; Brilique 90mg film-coated tablets 56: £54.60. Further information is available from: AstraZeneca UK Ltd., 600 Capability Green, Luton, LU1 3LU.

BRILIQUE is a trademark of the AstraZeneca group of companies.

CV 16 0083

Adverse Events should be reported. Reporting forms and information can be found at Adverse events should also be reported to AstraZeneca on 0800 783 0033.
Date of Preparation: August 17th 2017, end Date 17th November 2017 - GB 8410