CME Breakfast Symposium A · Friday, October 11, 2019 · 6:30 – 7:45 AM

Addressing the Unmet Need of Diabetic Kidney Disease Progression: Beyond SGLT-2 Inhibitors and GLP-1 Ras

Chaired by: George L. Bakris, MD

Diabetic kidney disease (DKD) is one of the most common complications of diabetes, affecting up to 50% of persons with diabetes, and leading to increased morbidity and mortality. Despite optimized glycemic control and renin-angiotensin-aldosterone system (RAAS) inhibitor therapy, many patients with DKD progress to kidney failure. Recent advances in the understanding of disease pathophysiology have opened up new avenues of treatment, including mineralocorticoid receptor antagonism, which have the potential to improve outcomes for patients with DKD. In particular, non-steroidal mineralocorticoid receptor antagonists (MRAs) have shown promise in DKD, as demonstrated in recent clinical trial results, and several phase III trials are ongoing.

During this symposium, experts will discuss recent and emerging clinical trial data with MRAs in DKD, particularly non-steroidal MRAs. In addition, they will provide an overview about the underlying pathophysiology, how to identify patients at high-risk, and the current management of DKD.

Learning Objectives
After completing this activity, the participant should be better able to:

• Review the association and the pathophysiology between T2D and CKD, and the impact of concomitant CKD and T2D on patient outcomes
• Employ the diagnostic criteria according to evidence-based guidelines for DKD in patients with T2DM at risk for kidney disease progression
• Utilize current treatment options for patients with DKD based on identified benefits and risks, and current guideline recommendations
• Review the efficacy and safety of emerging DKD treatments based on the latest evidence

This activity is jointly provided by Postgraduate Institute for Medicine and CMHC. Supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.

This activity is approved for AMA PRA Category 1 Credits™. This activity is eligible for ABIM MOC, ACPE, ANCC and CDR credit, see final activity announcement for specific details. For overall accreditation information on the 14th Annual CMHC, please click here.

CME Lunch Symposium A · Friday, October 11, 2019 · 12:20 – 1:35 PM

Reducing Cardiovascular Risk: A Paradigm Shift in T2DM Management

Chaired by: Robert H. Eckel, MD

Although the association between type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) remains complex, there is a dire need for comprehensive strategies to reduce the risk of adverse CV events in patients with T2DM. In recent years, several antihyperglycemic agents have shown that they not only improve glycemic parameters, but also reduce the risk of cardiovascular events, as demonstrated in multiple cardiovascular outcome trials (CVOT). These trials, originally designed to demonstrate CV safety, have provided valuable practice-changing insights that have shifted the focus of T2DM care beyond glucose control into CV risk management and prevention.

This symposium will provide clinicians with up-to-date information on the latest outcome trials, how to interpret their clinical practice implications and incorporate this evidence when individualizing therapy for patients with T2DM and cardiovascular risk.

Learning Objectives
After completing this activity, the participant should be better able to:

• Discuss the underlying links between CVD and T2DM and the burden of CVD in T2DM patient outcomes
• Interpret the current evidence from CV outcomes trials with antihyperglycemic agents, including SGLT-2 inhibitors and GLP-1 RAs, and their practice implications in patients with T2DM and CVD
• Develop individualized treatment regimens based on the latest evidence and guideline recommendations in order to minimize cardiovascular risk in patients with T2DMs

This activity is jointly provided by Annenberg Center for Health Sciences at Eisenhower and CMHC in collaboration with Postgraduate Institute for Medicine. Supported by an educational grant from Novo Nordisk.

This activity is approved for AMA PRA Category 1 Credits™. This activity is eligible for ABIM MOC, ACPE, ANCC and CDR credit, see final activity announcement for specific details. For overall accreditation information on the 14th Annual CMHC, please click here.

CME Breakfast Symposium A · Saturday, October 12, 2019 · 6:30 – 7:45 AM

The Potassium Dilemma in HF and CKD: Challenges and Advancements in the Management of Hyperkalemia

Chaired by: George L. Bakris, MD

Hyperkalemia is a serious condition associated with increased risk of mortality and is frequently prevalent and recurrent in patients who suffer from heart failure (HF), chronic kidney disease (CKD), and/or hypertension (HTN). Comorbid illnesses and use of medicines that are important for kidney and cardiac outcomes but elevate potassium levels can also increase the chronic risk for hyperkalemia.

Although the short-term management of hyperkalemia can be very effective, the utility of current strategies to manage hyperkalemia is limited, with no long-term outcome data to guide in the management of this condition. This symposium will provide clinicians with clinical evidence on the new potassium-binding agents for the long-term management of hyperkalemia to improve guideline adherence and help clinicians move toward optimizing guideline-directed medical therapy for hyperkalemic patients with HF and CKD.

Learning Objectives
After completing this activity, the participant should be better able to:

• Identify patients at risk for hyperkalemia based on the presence of several modifiable risk factors
• Evaluate the risk of hyperkalemia against the risk of discontinuing reno- and cardio-protective therapies based on evidence-based guideline recommendations for HF management and appropriate monitoring for renal function and hyperkalemia
• Interpret the efficacy and safety of current and new treatment options for hyperkalemia
• Develop appropriate treatment regimens for hyperkalemia in patients with HF and CKD based on the efficacy, safety, and mechanisms of action of current and new therapies

This activity is jointly provided by Postgraduate Institute for Medicine and CMHC. Multi-supported by educational grants from AstraZeneca and Relypsa, Inc.

This activity is approved for AMA PRA Category 1 Credits™. This activity is eligible for ABIM MOC, ACPE, ANCC and CDR credit, see final activity announcement for specific details. For overall accreditation information on the 14th Annual CMHC, please click here.

CME General Session · Saturday, October 12, 2019 · 8:30 – 9:00 AM

Treatment of High-Risk Patients with CVD and Elevated TGs: REDUCE-IT and Beyond

Chaired by: Deepak L. Bhatt, MD

Atherosclerotic vascular disease (ASCVD) is the leading cause of death in the United States. Lowering LDL cholesterol (LDL-C) remains central in the prevention and treatment of ASCVD, however, residual risk is present even after the optimization of LDL-C levels. Recent results with icosapent ethyl, as demonstrated by the REDUCE-IT trial, have shown that this agent can significantly reduce atherosclerotic events in high-risk hypertriglyceridemic patients with clinical ASCVD or type 2 diabetes and additional markers of increased risk. This session will review the role of elevated triglycerides on residual CVD risk, as well as the latest outcomes trials with emerging therapies that help address it and their clinical practice implications.

Learning Objectives
After completing this activity, the participant should be better able to:

• Recognize the importance of addressing residual CVD risk, including the role of elevated TG levels in atherosclerosis, based on the evidence and current guidelines
• Interpret the recent clinical evidence that addresses residual ASCVD risk in high-risk patients despite statin-controlled LDL-C

This activity is jointly provided by Postgraduate Institute for Medicine and CMHC. Supported by an educational grant from Amarin Pharma Inc.

This activity is approved for AMA PRA Category 1 Credits™. This activity is eligible for ABIM MOC, ACPE, ANCC and CDR credit, see final activity announcement for specific details. For overall accreditation information on the 14th Annual CMHC, please click here.

CME Lunch Symposium A · Saturday, October 12, 2019 · 12:00 – 1:15 PM

Challenges and Advances in the Diagnosis and Management of Heart Failure with Preserved Ejection Fraction

Chaired by: Mariell Jessup, MD, FAHA

Prognosis and treatment of heart failure patients with preserved ejection fraction (HFpEF) is complicated by diagnostic challenges and complicated pathophysiologies. Compared to HF patients with reduced ejection fraction (HFrEF), HFpEF patients are generally older, more often female, and have increased metabolic comorbidities such as obesity, hypertension, and type 2 diabetes mellitus. These metabolic comorbidities are associated with an increased risk of developing HFpEF, making the increase in metabolic syndrome in the recent decades particularly concerning. The lack of specific therapies for HFpEF have contributed to the increased prevalence and prognosis of the disease, and along with complicated diagnosis and pathophysiologies, contribute to the challenges that clinicians face in managing HFpEF. Advancements in disease pathophysiology, diagnostic tools, current and emerging treatment options may give clinicians additional tools to improve the outcomes of the disease; including morbidity, mortality, and quality of life.

To address these clinical practice gaps, expert faculty will focus on the latest evidence-based strategies to diagnose and manage HFpEF, including patients with comorbidities. This live symposium will also provide an overview on current and emerging resources and procedures designed to lower hospital readmission rates in HFpEF patients.

Learning Objectives
After completing this activity, the participant should be better able to:

• Identify HFpEF based on current and emerging diagnostic approaches
• Develop individualized treatment regimens for HFpEF patients with comorbidities based on current guidelines and evidence
• Interpret the efficacy and safety of emerging treatment options and therapeutic strategies in HFpEF based on the latest clinical trial evidence
• List approaches and resources aimed to improve hospital readmission rates for patients with HFpEF

This activity is jointly provided by Postgraduate Institute for Medicine and CMHC. Multi-supported by educational grants from Abbott and Novartis Pharmaceuticals Corporation.

This activity is approved for AMA PRA Category 1 Credits™. This activity is eligible for ABIM MOC, ACPE, ANCC and CDR credit, see final activity announcement for specific details. For overall accreditation information on the 14th Annual CMHC, please click here.

CME Lunch Symposium B · Saturday, October 12, 2019 · 12:00 – 1:15 PM

Advances in Iron Repletion Therapy: Addressing the Burden of Iron Deficiency in Patients with Heart Failure to Improve Outcomes and Quality of Life

Chaired by: Peter A. McCullough, MD, MPH

Iron deficiency (ID) affects up to one-third of the world's population and is particularly common in elderly individuals and those with certain chronic diseases such as chronic kidney disease, and congestive heart failure. Many of those affected are unaware of ID and cannot recognize its symptoms. For patients with heart failure (HF), ID is an independent predictor of outcomes and a major contributor to exercise intolerance. At least half of all patients with HF have comorbid ID; yet, the condition is under-recognized and untreated in most patients.

In this symposium, experts will provide participants with data from recent and ongoing trials of iron repletion in patients with HF to highlight the importance of diagnosis and proper management of this common comorbidity. Recent updates to established HF treatment guidelines that emphasize ID recognition and treatment will also be addressed. Additionally, the program will educate clinicians on the differences in oral versus intravenous iron formulations.

Learning Objectives
After completing this activity, the participant should be better able to:

• Define the prevalence of iron deficiency (ID) in heart failure (HF) and its impact on patient outcomes and quality of life
• Identify the symptoms of ID using appropriate markers in HF patients in order to diagnose ID
• Summarize the evidence from the latest clinical trials of iron repletion in HF patients with ID, as well as the updated ACC/AHA/HFSA guidelines for the management of iron deficiency in patients with HF
• Develop individualized treatment regimens to manage ID in HF patients, including the administration of intravenous iron, based on the latest evidence and current guideline recommendations

This activity is jointly provided by Postgraduate Institute for Medicine and CMHC. Supported by an educational grant from American Regent.

This activity is approved for AMA PRA Category 1 Credits™. This activity is eligible for ABIM MOC, ACPE, ANCC and CDR credit, see final activity announcement for specific details. For overall accreditation information on the 14th Annual CMHC, please click here.

CME Dinner Symposium · Saturday, October 12, 2019 · 7:20 – 8:35 PM

Managing LDL-C to Reduce ASCVD Risk: Recent Advancements and Strategies to Optimize Patient Outcomes

Chaired by: Christie M. Ballantyne, MD

During this live symposium, faculty will overview the management of hypercholesterolemia to reduce the risk of adverse atherosclerotic cardiovascular disease (ASCVD) events, including how to identify patients with statin intolerance or with residual risk despite maximized statin therapy, as well as current management of elevated cholesterol with statin and non-statin therapies according to the updated guidelines. In addition, the symposium will summarize the evidence on the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and emerging cholesterol-lowering therapies. Challenges with access to newer therapies and appropriate resources to address this issue will also be reviewed.

During the activity, case-based, patient simulation technology will be utilized to provide learners with the opportunity to explore different decision paths and get immediate feedback on their treatment decisions, allowing for enhanced competence in the individualization of therapy for patients at-risk for ASCVD.

Learning Objectives
After completing this activity, the participant should be better able to:

• Identify patients with elevated LDL-C who are statin intolerant based on past medical and familial history, adverse effects of statins, and recommended definitions and diagnostic guidelines
• List new and emerging treatment options for ASCVD prevention or management in high-risk patients with hypercholesterolemia
• Develop individualized treatment regimens for prevention of adverse cardiovascular events in high-risk patients with elevated LDL-C and comorbidities based on the current ACC/AHA guidelines and evidence about the safety and efficacy of non-statin therapies
• Employ strategies and resources designed to improve patients’ access to new treatment options for hypercholesterolemia that may minimize risk of adverse cardiovascular events

This activity is jointly provided by Postgraduate Institute for Medicine and CMHC. Multi-supported by educational grants from Sanofi US and Regeneron Pharmaceuticals and Esperion.

This activity is approved for AMA PRA Category 1 Credits™. This activity is eligible for ABIM MOC, ACPE, ANCC and CDR credit, see final activity announcement for specific details. For overall accreditation information on the 14th Annual CMHC, please click here.