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Antiplatelet Therapy in Patients with Coronary Artery Disease and Acute Ischemic Stroke/Transient Ischemic Attack: A Personalized Approach

  • Authors: Deepak L. Bhatt, MD, MPH; Karen L. Furie, MD, MPH; S. Claiborne Johnston, MD, PhD; Philippe Gabriel Steg, MD;
  • CME Released: 11/30/2021
  • Valid for credit through: 11/30/2022
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Target Audience and Goal Statement

This educational activity is intended for clinicians who manage patients with coronary artery disease and stroke/transient ischemic attack.

The goals of this program are to help clinicians:

  • Identify patients at high bleeding risk after percutaneous coronary intervention (PCI) for whom intensity or duration of dual antiplatelet therapy (DAPT) should be reduced.
  • Recognize patients with coronary artery disease (CAD) for whom extended duration of DAPT may be favored based on high ischemic risk.
  • Incorporate DAPT based on evidence from acute ischemic stroke/transient ischemic attack (TIA) study populations
  • Utilize DAPT in a timely manner and for the appropriate duration in acute ischemic stroke/TIA patients.

Upon completion of this activity, participants will:

  • Discuss antiplatelet therapy-focused strategies to reduce bleeding risk after PCI
  • Interpret evidence for extending DAPT in patients with CAD at high ischemic risk
  • Explain the efficacy and safety of DAPT with clopidogrel or ticagrelor plus aspirin (ASA) for reducing the risk of recurrent stroke in individuals who have experienced an acute ischemic stroke or TIA
  • Recognize the increased risk of recurrent stroke in the early period after an acute ischemic stroke or TIA, and the importance of timely administration of DAPT in appropriate patients


Voxmedia strives to ensure fair-balance, independence, objectivity, and scientific rigor in all directly or jointly sponsored educational activities. All prospective faculty are required to disclose to Voxmedia all financial relationships for the preceding 24 months (1) with any commercial interest producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients AND (2) with any commercial supporters prior to participating in the planning of an activity or developing content. Only after Voxmedia mitigates all financial relationships may faculty receive approval to participate, and are expected to contribute evidence-based material. Faculty are required to indicate areas of their presentation that are based on professional opinion vs. guidelines, meta-analysis . All information submitted will be peer-reviewed . The intent of this disclosure is not to prevent faculty from participating, but rather to provide learners with information on which they can make their own judgment of commercial bias. Voxmedia will disclose to learners that all relevant financial relationships have been mitigated in either written materials, visually, and/or verbally . It remains for the audience to determine whether the speaker's interests or relationships may influence the presentation. Speakers must make a meaningful disclosure to the audience of their discussions of any unlabeled or investigational use(s) of drugs or devices.


  • Deepak L. Bhatt, MD, MPH (Activity Chair)

    Executive Director of Interventional Cardiovascular Programs
    Brigham and Women’s Hospital Heart and Vascular Center
    Professor of Medicine
    Harvard Medical School
    Boston, Massachusetts, United States


    Deepak L. Bhatt, MD, MPH, has disclosed the following relevant financial relationships:
    Advisory Board: Boehringer Ingelheim; Cardax; CellProthera; Cereno Scientific; Elsevier Practice Update Cardiology; Janssen; Level Ex; Medscape Cardiology; MyoKardia; NirvaMed; Novo Nordisk; PhaseBio; PLx Pharma; Regado Biosciences; Stasys
    Board of Directors: Boston VA Research Institute; Society of Cardiovascular Patient Care; TobeSoft
    Chair: Inaugural Chair, American Heart Association Quality Oversight Committee
    Data Monitoring Committees: Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott); Boston Scientific (Chair, PEITHO trial); Cleveland Clinic (including for the ExCEED trial, funded by Edwards); Contego Medical (Chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo); Novartis; Population Health Research Institute
    Honoraria: American College of Cardiology (Senior Associate Editor, Clinical Trials and News,; Chair, ACC Accreditation Oversight Committee); Arnold and Porter law firm (work related to Sanofi/Bristol Myers Squibb clopidogrel litigation); Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim; AEGIS-II executive committee funded by CSL Behring); Belvoir Publications (Editor in Chief, Harvard Heart Letter); Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees); Cowen and Company; Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals); HMP Global (Editor in Chief, Journal of Invasive Cardiology); Journal of the American College of Cardiology (Guest Editor; Associate Editor); K2P (Co-Chair, interdisciplinary curriculum); Level Ex; Medtelligence/ReachMD (CME steering committees); MJH Life Sciences; Piper Sandler; Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer); Slack Publications (Chief Medical Editor, Cardiology Today’s Intervention); Society of Cardiovascular Patient Care (Secretary/Treasurer); WebMD; (CME steering committees)
    Other: Clinical Cardiology (Deputy Editor); NCDR-ACTION Registry Steering Committee (Chair); VA CART Research and Publications Committee (Chair)
    Research Funding: Abbott; Afimmune; Amarin; Amgen; AstraZeneca; Bayer; Boehringer Ingelheim; Bristol Myers Squibb; Cardax; CellProthera; Cereno Scientific; Chiesi; CSL Behring; Eisai; Ethicon; Faraday Pharmaceuticals; Ferring Pharmaceuticals; Forest Laboratories; Fractyl; Garmin; HLS Therapeutics; Idorsia; Ironwood; Ischemix; Janssen; Lexicon; Lilly; Medtronic; MyoKardia; NirvaMed; Novartis; Novo Nordisk; Owkin; Pfizer; PhaseBio; PLx Pharma; Regeneron; Roche; Sanofi; Stasys; Synaptic; The Medicines Company; 89Bio
    Royalties: Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease)
    Site Co-Investigator: Abbott; Biotronik; Boston Scientific; CSI; Philips; St. Jude Medical (now Abbott); Svelte
    Trustee: American College of Cardiology
    Unfunded Research: FlowCo; Merck; Takeda

  • Karen L. Furie, MD, MPH

    Professor of Clinical Neuroscience
    Chair of Neurology
    The Warren Alpert Medical School of Brown University
    Providence, Rhode Island, United States


    Karen L. Furie, MD, MPH, has disclosed the following relevant financial relationships:
    Executive Committee for Clinical Trial: Janssen
    Editor: Journal of Neurology, Neurosurgery, and Psychiatry
    Stroke Journal Senior Consulting Editor: American Heart Association/American Stroke Association
    Author: UpToDate

  • S. Claiborne Johnston, MD, PhD

    Special Assistant to the President and Provost
    Professor of Neurology
    Dell Medical School
    The University of Texas at Austin
    Austin, Texas, United States


    S. Claiborne Johnston, MD, PhD, has disclosed the following relevant financial relationships:
    Research support: AstraZeneca (SOCRATES and THALES)
    Institutional research support: Janssen/Bristol Myers Squibb
    Received drug and placebo from Sanofi for a National Institutes of Health-sponsored trial (POINT)
    Data and Safety Monitoring Board unblinded clinician for a trial sponsored by AstraZeneca

  • Philippe Gabriel Steg, MD

    Professor of Cardiology
    Université Paris–Diderot
    Département de Cardiologie
    Hôpital Bichat
    Paris, France


    Philippe Gabriel Steg, MD, has disclosed the following relevant financial relationships:
    Research Grants: Amarin; Bayer; Sanofi; Servier
    Clinical Trials (Steering Committee, CED, DSMB): Amarin; AstraZeneca; Boehringer Ingelheim; Bristol Myers Squibb; Idorsia; Novartis; Pfizer; Sanofi; Servier
    Consulting or Speaking: Amarin; Amgen; Bristol Myers Squibb/Myokardia; Novo Nordisk; Regeneron
    Senior Associate Editor: Circulation


  • John F. Kocsis, PhD

    Hazlet, New Jersey, United States


    John F. Kocsis, PhD, has disclosed no relevant financial relationships.

Accreditation Statements

Voxmedia LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    For Physicians

  • Voxmedia designates this activity for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Contact this provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 80% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.


Antiplatelet Therapy in Patients with Coronary Artery Disease and Acute Ischemic Stroke/Transient Ischemic Attack: A Personalized Approach

Authors: Deepak L. Bhatt, MD, MPH; Karen L. Furie, MD, MPH; S. Claiborne Johnston, MD, PhD; Philippe Gabriel Steg, MD;Faculty and Disclosures

CME Released: 11/30/2021

Valid for credit through: 11/30/2022


Before you begin, please answer the questions in this brief questionnaire.