Release date: August 16, 2013
Expiration date: August 16, 2014
Estimated time to complete activity: 1.75 hours
Media: Internet
Course viewing requirements:
PC: Internet Explorer (v6 or greater), Google Chrome, or Firefox
MAC: Safari or Firefox

This enduring activity was developed from a live satellite symposium that took place on May 2, 2013

Needs Assessment
Data from the National Health and Nutrition Examination Survey (1999- 2008) showed there were >70 million persons in the U.S., or ~1/3 of the adult population, with hypertriglyceridemia (HTG, defined as TG levels ≥150 mg/dL). Use of TG levels as a biomarker for cardiovascular disease (CVD) has proven elusive in clinical practice, despite the identification of elevated TG levels as a significant CVD risk factor (even after adjustment for total cholesterol, LDL-C, and/or HDL-C). Because there are many TG-lowering agents in the testing stage, and much new data to integrate, the recommendations of the AHA and ADA regarding consumption of Omega-3 and other TG-lowering agents such as nicotinic acid and bile acid sequestrants may change soon, creating a gap in knowledge and practice. The rationale for change and clinical practice updates requires a major educational effort targeting clinicians to improve outcomes in patients with HTG.

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

Target Audience
This activity has been designed to meet the educational needs of Clinical Endocrinologists, Endocrinology Fellows-in-training, Diabetologists, and Allied Healthcare Providers involved in the care of patients with elevated triglycerides.

Requirements for Successful Completion

Accreditation Statement
The American Association of Clinical Endocrinologists (AACE) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The American Association of Clinical Endocrinologists (AACE) designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty
Harold E. Bays, MD, FTOS, FACE, FNLA, Chair
Medical Director/President
L-MARC Research Center
Louisville, KY

William C. Cromwell, MD, FAHA, FNLA
Chief, Lipoprotein and Metabolic Disorders Institute
Raleigh, NC
Adjunct Associate Professor
Wake Forest University School of Medicine
Winston-Salem, NC

Tara Dall, MD
Medical Director/President
Advanced Lipidology
Delafield, WI

James R. Gavin III, MD, PhD
CEO & Chief Medical Officer
Healing Our Village, Inc.
Clinical Professor of Medicine
Emory University School of Medicine
Atlanta, GA

Disclosure Information
Declaration of Disclosure and Conflicts of Interest
It is the policy of AACE to ensure balance, independence, objectivity and scientific rigor in all of its CME activities. Presentation content may include discussion of an unlabeled or an investigational use of a product. AACE requires that participating faculty disclose to the audience any product(s) and its use(s) discussed in the educational activity that are unapproved/unlabeled for the use by the FDA or still considered investigational in nature.

Everyone who is in a position to control the content of an educational activity must disclose all relevant financial relationships. “Relevant financial relationships” are financial relationships in any amount occurring within the past 12 months that create a conflict of interest. AACE requires speakers, faculty, CME Committee and other individuals who are in a position to control the content of this educational activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly evaluated by AACE for fair balance, scientific objectivity of studies mentioned in the presentation and educational materials used as basis for content, and appropriateness of patient care recommendations.

The intent of this disclosure is not to prevent a speaker with commercial affiliations from presenting, but rather to provide learners with information from which they may make their own judgments. Informed learners are the final safeguards in assuring that a CME activity is independent from commercial influence.

AACE has reviewed all disclosures and resolved or managed all identified conflicts of interest for this educational activity, as applicable.

CME Accreditation Committee Disclosures
Dr. Fernando Ovalle reports that he has received speaker/consultant honoraria and research grant support for his role as an investigator from Janssen Pharmaceuticals, Inc, and consultant honoraria and research grant support for his role as an investigator from Novo Nordisk A/S and sanofi-aventis US LLC.

Dr. Mushtaq A. Syed reports that he has received speaker and consultant honoraria from Janssen Pharmaceuticals, Inc., Novo Nordisk A/S, and Takeda Pharmaceutical Company Limited. 

Dr. Joseph M. Tibaldi reports that he has received speaker honoraria from Daiichi-Sankyo company, Limited, Janssen Pharmaceuticals, and Merck & Co., Inc., and speaker/consultant honoraria from Novo Nordisk A/S.

Dr. Dace L. Trence reports that she has received research grant support from Eli Lilly and Company and is a stockholder of Medtronic, Inc. and sanofi-aventis U.S. LLC. 

Faculty Disclosures
Dr. Harold Bays reports that he has received clinical research grant support from Novo Nordisk A/S and Orexigen Therapeutics, Inc.; speaker honoraria and clinical research grant support from Abbott Laboratories, Amarin Corp., AstraZeneca, Eisai Inc., GlaxoSmithKline plc., Merck & Co., Inc., and Vivus, Inc. He also reports that his presentation will include discussion of investigational or unlabeled use(s) of icosapent ethyl in lowering of TG, CRP, and other metabolic effects. Dr. Bays has an identified conflict of interest and it has been resolved accordingly. He has been advised by the AACE CME Accreditation Committee to base his presentation and recommendations on the best available, preferably published evidence/information.

Dr. William Cromwell reports that he has received speaker honoraria from AbbVie Inc., Amarin Corp., LipoScience Inc., and Merck & Co., Inc. He also reports that his presentation will not include discussion of any investigational or unlabeled use(s) of a product. Dr. Cromwell has an identified conflict of interest and it has been resolved accordingly. He has been advised by the AACE CME Accreditation Committee to base his presentation and recommendations on the best available, preferably published evidence/information.

Dr. Tara Dall reports that she does not have any relevant financial relationships with any commercial interests. She also reports that her presentation will not include discussion of any investigational or unlabeled use(s) of a product. Dr. Dall has no identified conflicts of interest.

Dr. James Gavin reports that he has received speaker honoraria from Boehringer Ingelheim GmbH/ Eli Lilly and Company and Bristol-Myers Squibb Company/AstraZeneca; service provider fees from sanofi-aventis U.S. LLC; advisor fees from Abbott Laboratories and Vivus, Inc.; and consultant fees from Janssen Pharmaceuticals, Inc. He also reports that his presentation will not include discussion of any investigational or unlabeled use(s) of a product. Dr. Gavin has an identified conflict of interest and it has been resolved accordingly. He has been advised by the AACE CME Accreditation Committee to base his presentation and recommendations on the best available, preferably published evidence/information.

Bibliography
1. American Diabetes Association. Diabetes Care. 2012;35(Suppl 1):S11-S63.
2. Ballantyne CM et al. Am J Cardiol. 2012;110:984-92.
3. Bays HE et al. Am J Cardiol. 2011;108:682-90.
4. Brunzell JD et al. J Am Coll Cardiol. 2008;51:1512-24.
5. Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2012;33:1635-1701.
6. Jellinger PS et al. Endocr Pract. 2012;18(Suppl 1):1-78.
7. Miller M et al. Circulation. 2011;123:2292-333.
8. NCEP Expert Panel. Circulation. 2002;106:3143-421.
9. Sarwar N et al. Circulation. 2007;30:115:450-8.
10. Sniderman AD et al. Circ Cardiovasc Qual Outcomes. 2011;4:337-45.
11. Triglyceride Coronary Disease Genetics Consortium and Emerging Risk Factors Collaboration. Lancet. 2010;375:1634-9.

Copyright 2013, AACE. All rights reserved. No part of this publication may be reproduced or transmitted in any other form or by any other means, electronic or mechanical, without first obtaining written permission from AACE.

Learner Bill of Rights
The American Association of Clinical Endocrinologists (AACE) recognizes that you are a life-long learner who has chosen to engage in continuing medical education to identify or fill a gap in knowledge, skill or performance. As part of AACE’s duty to you as a learner, you have the right to expect that your continuing medical education experience with AACE includes:
CONTENT that:

A LEARNING ENVIRONMENT that:

DISCLOSURE of:

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This activity is sponsored by the American Association of Clinical Endocrinologists 

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This activity is supported by an educational grant from Amarin Pharma Inc. Amarin logo jpeg.JPG

For questions regarding this CME activity, please contact:
AACE c/o Lauren Hogan
Phone: (904) 353-7878
Email:  lhogan@aace.com

To launch the online activity, please click here to attest that you have read and understood the CME required elements: