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National Association For Continuing Education

Course Directors
Gregg Sherman, MD
Chief Medical Officer, NACE
Plantation, FL

Deborah Paschal, CRNP
Clinical Nurse Practitioner
Cardiothoracic Surgery Division
Penn-Presbyterian Medical Center
Philadelphia, PA

Medical Writer
Josh Kilbridge
Kilbride Associates Healthcare Communications
San Francisco, CA

John M. Fontaine, MD, FACC
Professor of Medicine
Director Arrhythmia Services
Drexel University College of Medicine
Philadelphia, PA

Anekwe Onwuanyi, MD
Professor of Medicine
Chief Cardiology
Morehouse School of Medicine
Medical Director, Heart Failure Program
Grady Health System
Atlanta, GA

Daniel Thibodeau, MHP, PA-C, DFAAPA
Associate Professor
Physician Assistant Program School
Eastern Virginia Medical School
Norfolk, VA

Marcus Wharton, MD
Frank P. Tourville Professor of Medicine
Director, Cardiac Electrophysiology
Medical University of South Carolina
Charleston, SC

: Atrial Fibrillation: Reducing Risk and Individualizing Therapeutic Choices
Activity/Course #:
: NCME317x

: Free
Release/Start Date:
: Feb 01 2017
Expiration Date:
: Jan 31 2018
: Cardiovascular
Target Audience:
: Primary Care Providers
: Monograph
Estimated Time To Complete CME Activity:
: 1.0 Hour
: 0
Hardware/Software Requirements:
This monograph reviews the benefits, risks, and appropriate use of oral anticoagulants, with a focus on issues relevant to the primary care setting. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Over 5 million Americans have AF, and, as the population ages, the prevalence is expected to more than double in coming decades, reaching 12.1 million by 2030. A major risk of AF is thromboembolic stroke; the annual risk for stroke in AF is roughly 5%, and about 15% of all strokes in the US – more than 70,000 strokes each year – can be attributed to AF.

To reduce stroke risk in patients with AF, oral anticoagulation is recommended by guidelines and supported by strong and extensive evidence. However, oral anticoagulants are associated with potentially serious risks, most notably the risk for major bleeding. The long-established oral anticoagulant warfarin is further complicated by the need for frequent monitoring to maintain safe and effective drug levels. The new class of direct oral anticoagulants (DOACs) does not require therapeutic monitoring and has demonstrated reduced risk for intracranial hemorrhage compared to warfarin. But these agents too have their drawbacks, including risk for gastrointestinal (GI) bleeding and the lack of specific reversal agents for most DOACs. As a result of these and other challenges, oral anticoagulation is widely underused, leaving many patients with AF at elevated risk for stroke and mortality.

Learning Objective(s):

After completing this program participants should be able to:

  1. Identify those patients at risk for cardioembolic stroke who are appropriate candidates for anticoagulation.
  2. Recognize common misperceptions about anticoagulation risk to improve communication and patient adherence.
  3. Discuss the management of bleeding in patients on anticoagulants.
  4. Describe the role of continued anticoagulation in the setting of emerging non-pharmacologic therapy.

How To Obtain Your CME Certificate

  1. Register for the course at
  2. View the content.
  3. Complete and submit the post-test and evaluation.
  4. A minimum passing score of 80% must be earned on the post-test in order to complete the CME activity.
  5. Print your CME certificate.
Sponsored and Certified By
National Association for Continuing Education
Accreditation Designation Statement
The National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The National Association for Continuing Education designates this enduring activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.

National Association for Continuing Education is approved as a provider of nurse practitioner continuing education by the American Association of Nurse Practitioners. AANP Provider Number 121222. This program has been approved for 1.0 contact hour of continuing education(which includes 0.50 pharmacology hours).
Faculty Disclosure Policy
Policy on Faculty and Provider Disclosure: It is the policy of the National Association for Continuing Education to ensure fair balance, independence, objectivity and scientific rigor in all activities. All faculty participating in CME activities sponsored by the National Association for Continuing Education are required to present evidence-based data, identify and reference off-label product use and disclose all relevant financial relationships with those supporting the activity or others whose products or services are discussed. Faculty disclosures are provided below.

John M. Fontaine, MD, FACC, Faculty, has no relationships to disclose.

Anekwe Onwuanyi, MD, Faculty, serves a Speaker – Novartis Pharmaceuticals Corporation.

Daniel Thibodeau, MHP, PA-C, DFAAPA, Faculty, has no relationships to disclose.

Marcus Wharton, MD, Faculty, conducts clinical trial research – BMS and Pfizer.

Gregg Sherman, MD, Co-Course Director, has no relationships to disclose.

Deborah Paschal, CRNP, Co-Course Director, has no relationships to disclose.

Josh Kilbridge, Medical Writer, has no relationships to disclose.

Harvey C. Parker, Ph.D., Activity Planning Committee, has no relationships to disclose.

Michelle Frisch, MPH, Activity Planning Committee, has no relationships to disclose.

Alan Goodstat, LCSW, Activity Planning Committee, has no relationships to disclose.

Cheryl C. Kay, Activity Planning Committee, has no relationships to disclose.
Commercial Support
This activity is supported by is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.