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Slide Lecture Programs
2008 Core Curriculum
A Team Approach to Reducing Cardiometabolic Risk and Hyperglycemia in ACS: Blueprint for Success
November 21, 2008
Table of Contents - 117 slides
No.  Title
1  A Team Approach to Reducing Cardiometabolic Risk and Hyperglycemia in ACS: Blueprint for Success
2  A two-part educational slide library
3  Cardiometabolic Risk Reduction: Mechanistic Rationale and the Burden of Proof
4  Section overview: Cardiometabolic risk reduction
5  Contributing factors in cardiometabolic risk
6  Risk of T2DM increases as cardiometabolic risk factors increase
7  The evolving view of adipose tissue as an endocrine organ
8  Visceral adiposity associated with increased levels of IL-6
9  Pathologic effects of nutritional overload
10  Consequences of ectopic fat deposition
11  Epicardial fat is associated with myocardial dysfunction in humans
12  Evolving view of cardiometabolic risk: Summary
13  Lifestyle Modification and Weight Loss
14  Healthful dietary and lifestyle factors positively impact survival in the elderly
15  Assessment and management of metabolic risk
16  Lifestyle therapy to reduce plasma glucose and lower risk for T2DM
17  Guide to adiposity management
18  NHLBI guidelines: Weight loss goals
19  NHLBI guidelines: Lifestyle modification
20  Popular dietary programs: Effective yet difficult to maintain
21  ADA: Dietary recommendations
22  Popular diets vary widely in macronutrient composition, confusing patients
23  Helping patients with portion size
24  Regular follow-up and support for lifestyle modification blunts weight regain
25  Lifestyle modification and pharmacotherapy: Potentially additive effects
26  Drugs associated with weight gain
27  Physical activity may reduce CV and all-cause mortality
28  Women’s Health Study: Joint effect of weight and physical activity on CV disease risk
29  STRRIDE: Vigorous physical activity may be required for significant weight loss
30  Lifestyle modification and weight loss: Summary
31  Pharmacologic Strategies
32  Currently approved pharmacologic options for long-term weight management
33  Weight loss with orlistat: Meta-analysis
34  Orlistat: Change in cardiometabolic parameters
35  Weight loss with sibutramine: Meta-analysis
36  Sibutramine: Change in cardiometabolic parameters
37  New targets for weight loss and cardiometabolic risk reduction
38  Exenatide: Effects on weight
39  Pramlintide: Effects on weight
40  Pramlintide plus recombinant leptin for weight loss: Pilot study
41  New systems targeting cardiometabolic risk reduction: Summary
42  Weight Loss on Progression of Disease
43  Look AHEAD: Study design
44  Look AHEAD: Patients meeting risk factor goals at 1 year
45  SCOUT: Study design
46  SCOUT: Change in cardiometabolic risk factors during lead-in phase
47  SOS: Study design
48  SOS: Weight change by treatment over time
49  Surgical weight loss is associated with remission of diabetes
50  SOS: Mortality reduction with weight-loss surgery
51  SOS: Causes of death
52  Long-term mortality after gastric bypass surgery
53  Gastric bypass surgery and matched controls: Causes of death
54  Effects of weight loss on progression of cardiovascular and metabolic disease: Summary
55  Cardiometabolic risk reduction: Mechanistic rationale and the burden of proof: Summary
56  Hyperglycemia in Acute Coronary Syndromes: Vascular Implications and In-hospital Management
57  Section overview: Hyperglycemia in ACS
58  Diabetes increases risk of fatal MI despite advances in cardiac care
59  Admission glucose and mortality
60  Hyperglycemia is associated with higher risk of occluded infarct-related artery
61  Preoperative glucose levels and perioperative mortality
62  Defining the optimal measure of risk
63  Comparing glucometrics
64  Association between mean blood glucose and in-hospital mortality
65  Fasting glucose and 4-year incidence of CHD: Effect of gender
66  Detrimental physiologic impact of hyperglycemia
67  Molecular pathways affected by hyperglycemia
68  Acute glucose fluctuations are associated with oxidative stress
69  Abnormal glucose regulation associated with more lipid-rich plaque
70  Hyperglycemia is associated with no reflow
71  Physiologic impact of hyperglycemia: Questions remain
72  In-hospital Insulin Strategies
73  Cardioprotective actions of insulin
74  Differing effects of insulin and acute hyperglycemia on myocardial ischemia/reperfusion injury
75  Insulin therapy for critically ill patients: Key advances and clinical settings
76  Intensive vs conventional glucose control in the medical ICU: Study design
77  Intensive vs conventional insulin treatment in the medical ICU: In-hospital mortality
78  Intensive vs conventional insulin treatment in the medical ICU: Reduced morbidity
79  Yale-Mid America Heart Institute protocol: Performance in ACS
80  Insulin therapy for noncritically ill patients
81  Glycemic control in patients treated with sliding-scale insulin
82  RABBIT 2: Superior glycemic control with basal-bolus vs sliding-scale insulin
83  RABBIT 2: Glycemic control rapidly improved after switching to basal-bolus insulin regimen
84  Myocardial energy production: Rationale for addition of glucose to insulin regimens
85  GIK clinical development: 1965-2005
86  Early and late effects of GIK infusion
87  Possible explanations for early effect of GIK in AMI
88  CREATE-ECLA re-analysis: Observed vs estimated 30-day mortality
89  Modified GIK regimen blunts FFA rise and suppresses pro-MMP-1
90  HI-5: Study design
91  HI-5: Treatment effects on glucose level and morbidity/mortality
92  HI-5: Mortality correlated with mean 24-hour blood glucose
93  HI-5: Study limitations
94  Ongoing trials of insulin therapy in ACS
95  ADA: Glycemic targets in hospitalized patients
96  AHA Scientific Statement: In-hospital treatment of hyperglycemia in ACS
97  Suboptimal glucose control in hospitalized patients
98  Suggested strategies for improving management of hyperglycemia in hospitalized patients
99  In-hospital therapeutic strategies for insulin: Summary
100  Post-Discharge and Beyond
101  ACC/AHA UA/NSTEMI and STEMI guidelines: Post-discharge management of patients with diabetes
102  DIGAMI 2 post-hoc analysis: Glucose-lowering drugs and long-term outcome
103  Observational studies of insulin and clinical outcomes
104  Insulin and clinical outcomes: Limitations of available data
105  ACCORD, ADVANCE: Addressing 3 key questions
106  ACCORD: Study design
107  ADVANCE: Study design
108  ACCORD: Treatment effects on glucose control
109  ACCORD: Treatment effect on primary outcome
110  ACCORD: Treatment effect on all-cause mortality
111  ADVANCE: Treatment effect on glucose control
112  ADVANCE: Treatment effect on primary macrovascular outcome
113  ADVANCE: Treatment effect on all-cause mortality
114  VADT: Effect of intensive therapy on A1C
115  VADT: Effect of intensive therapy on time to major CV event
116  ACCORD, ADVANCE, VADT: Long-term glycemic control in high-risk T2DM
117  Post-discharge, long-term glycemic control: Summary


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