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Are You Selecting the Right Antiplatelet for the Right Patient for the Right Reasons?

  • Authors: Ajay Kirtane, MD, SM, FACC, FSCAI
  • CME / ABIM MOC / CE Released: 2/21/2023
  • Valid for credit through: 2/21/2024, 11:59 PM EST
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  • Credits Available

    Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.25 ABIM MOC points

    Pharmacists - 0.25 Knowledge-based ACPE (0.025 CEUs)

    IPCE - 0.25 Interprofessional Continuing Education (IPCE) credit

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for cardiologists, emergency medicine physicians, anesthesiologists, and pharmacists.

The goal of this activity is for learners to be better able to evaluate knowledge and educational gaps in the use of antiplatelet agents during PCI.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Current guideline recommendations for antithrombotic use during PCI
  • Self-assess learning needs related to
    • Choosing treatment plans for select patients undergoing PCI in various settings


Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


  • Ajay Kirtane, MD, SM, FACC, FSCAI

    Professor of Medicine
    Columbia University Irving Medical Center
    New York, New York


    Ajay Kirtane, MD, SM, FACC, FSCAI, has the following relevant financial relationships: 
    Consultant or advisor for: IMDS
    Research funding from: Abbott Vascular; Amgen, Inc.; BIOTRONIK; Bolt Medical; Boston Scientific; Canon; Cardiovascular Systems, Inc.; Chiesi Pharmaceuticals, Inc.; Magenta Medical; Medtronic, Inc.; Merck & Co., Inc.; Neurotronic; Philips; ReCor Medical; Shockwave Medical; SoniVie 
    Other: Travel Expenses/Meals: Abbott Vascular; Boston Scientific; Cardiovascular Systems, Inc.; Chiesi USA; Medtronic, Inc.; OpSens; Philips; ReCor Medical; Regeneron Pharmaceuticals, Inc.; Siemens Healthcare Diagnostics Inc.; Zoll Medical Corporation


  • Jennifer Hakkarainen, PA-C

    Medical Education Director, Medscape, LLC


    Jennifer Hakkarainen, PA-C, has no relevant financial relationships.

  • Gina Montanero, PharmD

    Associate Medical Writer, Medscape, LLC


    Gina Montanero, PharmD, has no relevant financial relationships. 

Compliance Reviewer

  • Esther Nyarko, PharmD

    Director, Accreditation and Compliance, Medscape, LLC


    Esther Nyarko, PharmD, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

Accreditation Statements


Interprofessional Continuing Education

In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


This activity was planned by and for the healthcare team, and learners will receive 0.25 Interprofessional Continuing Education (IPCE) credit for learning and change.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

    Contact This Provider

    For Pharmacists

  • Medscape, LLC designates this continuing education activity for 0.25 contact hour(s) (0.025 CEUs) (Universal Activity Number JA0007105-0000-23-061-H01-P).

    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 70% 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.


Are You Selecting the Right Antiplatelet for the Right Patient for the Right Reasons?

Authors: Ajay Kirtane, MD, SM, FACC, FSCAIFaculty and Disclosures

CME / ABIM MOC / CE Released: 2/21/2023

Valid for credit through: 2/21/2024, 11:59 PM EST



  1. Collet JP, et al; ESC Scientific Document Group. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42:1289-1367.
  2. Lawton JS, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022;79:e21-e129.
  3. Ndrepepa G, et al. Periprocedural bleeding and 1-year outcome after percutaneous coronary interventions: appropriateness of including bleeding as a component of a quadruple end point. J Am Coll Cardiol. 2008;51:690-697.
  4. De Luca LD, et al. Cangrelor: clinical data, contemporary use, and future perspectives. J Am Hear Assoc Cardiovasc Cerebrovasc Dis. 2021;10:e022125.
  5. Angiolillo DJ, et al. International expert consensus on switching platelet P2Y12 receptor-inhibiting therapies. Circulation. 2017;136:1955-1975.
  6. Wallentin L, et al; PLATO Investigators. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361:1045-1057.
  7. Wiviott SD, et al; TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007;357:2001-2015.
  8. Masoudi FA, et al. Trends in U.S. cardiovascular care: 2016 report from 4 ACC national cardiovascular data registries. J Am Coll Cardiol. 2017;69:1427-1450.
  9. Capodanno D, et al. Intravenous antiplatelet therapies (glycoprotein IIb/IIIa receptor inhibitors and cangrelor) in percutaneous coronary intervention: from pharmacology to indications for clinical use. Ther Adv Cardiovasc Dis. 2019;13:1753944719893274.
  10. Kastrati A, et al. A clinical trial of abciximab in elective percutaneous coronary intervention after pretreatment with clopidogrel. N Engl J Med 2004;350:232-238
  11. Mehilli J, et al; Intracoronary Stenting and Antithrombotic Regimen: Is Abciximab a Superior Way to Eliminate Elevated Thrombotic Risk in Diabetics (ISAR-SWEET) Study Investigators. Randomized clinical trial of abciximab in diabetic patients undergoing elective percutaneous coronary interventions after treatment with a high loading dose of clopidogrel. Circulation. 2004;110:3627-3635.
  12. Kirtane AJ, et al. The long-awaited revascularization guidelines are out: what’s in them? Circulation. 2021;145:155-157.
  13. Schüpke S, et al; ISAR-REACT 5 Trial Investigators. Ticagrelor or prasugrel in patients with acute coronary syndromes. N Engl J Med. 2019;381:1524-1534.
  14. Franchi F, et al. Platelet inhibition with cangrelor and crushed ticagrelor in patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention. Circulation. 2019;139:1661-1670.
  15. Franchi F, et al. Cangrelor in patients with coronary artery disease pretreated with ticagrelor: the switching antiplatelet (SWAP)-5 study. JACC Cardiovasc Interv. 2023;16:36-46.
  16. Salgia A, et al. Perioperative antiplatelet bridging with cangrelor: a cohort study and narrative review. Ann Pharmacother. 2022:10600280221120310.
  17. Angiolillo DJ, et al. Bridging antiplatelet therapy with cangrelor in patients undergoing cardiac surgery: a randomized controlled trial. JAMA. 2012;307:265-274.
  18. Rossini R, et al. A multidisciplinary approach on the perioperative antithrombotic management of patients with coronary stents undergoing surgery: surgery after stenting 2. JACC Cardiovasc Interv. 2018;11:417-434.
  19. Harrington RA, et al. Platelet inhibition with cangrelor in patients undergoing PCI. N Engl J Med. 2009;361:2318-2329.
  20. Bhatt DL, et al; CHAMPION PLATFORM Investigators. Intravenous platelet blockade with cangrelor during PCI. N Engl J Med. 2009;361:2330-2341.
  21. Bhatt DL, et al; CHAMPION PHOENIX Investigators. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med. 2013;368:1303-1313.
  22. Steg PG, et al. Effect of cangrelor on periprocedural outcomes in percutaneous coronary interventions: a pooled analysis of patient-level data. Lancet. 2013;382:1981-1992.
  23. Winchester DE, et al. Efficacy and safety of glycoprotein IIb/IIIa inhibitors during elective coronary revascularization: a meta-analysis of randomized trials performed in the era of stents and thienopyridines. J Am Coll Cardiol. 2011;57:1190-1199.
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