Weighing the Evidence: A Pharmacy Approach to Stroke Prevention in Obese Patients with NVAF


Executive Director of Interventional Cardiovascular Programs, Brigham and Women's Hospital Heart & Vascular Center
Professor of Medicine, Harvard Medical School, Boston, MA

After graduating as valedictorian from Boston Latin School, Dr. Bhatt obtained his undergraduate science degree as a National Merit Scholar at MIT while also serving as a research associate at Harvard Medical School. He received his medical doctorate from Cornell University and a Master of Public Health with a concentration in clinical effectiveness from Harvard University. His internship and residency in internal medicine were at the Hospital of the University of Pennsylvania, and his cardiovascular training was at Cleveland Clinic. Dr. Bhatt completed fellowships in interventional cardiology and cerebral and peripheral vascular intervention and served as Chief Interventional Fellow at Cleveland Clinic, where he spent several years as an interventional cardiologist and an Associate Professor of Medicine. Most recently he received the AHA’s Distinguished Scientist Award in 2019 in addition to numerous other honors. Dr. Bhatt has been listed in Best Doctors in America from 2005 to 2020.

Dr. Bhatt’s research interests include acute coronary syndromes, preventive cardiology, and advanced techniques in cardiac, cerebral, and peripheral intervention. He has authored or co-authored over 1500 publications and has been listed by the Web of Science Group as a Highly Cited Researcher from 2014 to 2019. He was the international PI for the CHARISMA and CRESCENDO trials and co-PI of the three CHAMPION trials. He served as chair of COGENT and co- PI of STAMPEDE. Additionally, Dr. Bhatt serves as chair for REDUCE- IT and SCORED. In 2018, REDUCE-IT was listed and named the top cardiology trial by NEJM. In 2014, he was listed in the AHA/ASA top ten advances in heart disease and stroke research (for STAMPEDE and SYMPLICITY HTN-3).He serves as Senior Associate Editor for News and Clinical Trials for ACC.org, Editor of the peer-reviewed Journal of Invasive Cardiology, as well as Editor of Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease and Atherothrombosis in Clinical Practice published by Oxford University Press. He also serves as Editor-in-Chief of the Harvard Heart Letter for patients.

Kazuhiko Kido, PharmD, MS, BCCP, BCPS
Clinical Assistant Professor of Clinical Pharmacy, West Virginia University School of Pharmacy, Morgantown, WV
Kazuhiko Kido, PharmD, MS, BCCP, BCPS

Dr. Kido is currently a clinical assistant professor of clinical pharmacy at West Virginia University School (WVU) of Pharmacy. Dr. Kido graduated from University of Iowa College of Pharmacy and completed his PGY 1 pharmacy practice residency and PGY 2 cardiology pharmacy residency at University of Kentucky HealthCare. He also received his Master of Science Degree from Keio University and his Bachelor of Science Degree from Kyoritsu College of Pharmacy in Japan.

Dr. Kido is a cardiology clinical pharmacy specialist in the WVU outpatient heart failure clinic and on the WVU inpatient heart failure service. His areas of research interests include anticoagulation in morbidly obese populations and the optimization of sacubitril/valsartan in real-world settings. Dr. Kido has published multiple original research articles and review articles in peer-reviewed journals. Dr. Kido is an active member in the American College of Clinical Pharmacy and American Society of Health-System Pharmacist. He currently serves as a committee member for multiple national pharmacy associations.

Edith Nutescu, PharmD, MS CTS, FCCP
Michael Reese Endowed Professor of Cardiovascular Pharmacotherapy
Award for Excellence in Medication-Use Safety, American Society of Health System Pharmacists Foundation
Clinical Practice Award, American College of Clinical Pharmacy
Edith Nutescu, PharmD, MS CTS, FCCP

Edith Nutescu, Pharm.D., MS CTS, FCCP, is the Michael Reese Endowed Professor of Cardiovascular Pharmacotherapy and Head of the Department of Pharmacy Practice at University of Illinois at Chicago (UIC) College of Pharmacy. She also serves as the Co- Director of the Personalized Medicine Program at the University of Illinois Hospital and Health Sciences System (UI – Health) and is Affiliate Faculty in the Center for Pharmacoepidemiology and Pharmacoeconomic Research and Center for Dissemination and Implementation Science. Dr. Nutescu received her Doctor of Pharmacy from the UIC College of Pharmacy and her Master in Clinical and Translational Science from the UIC School of Public Health. She completed Pharmacy Practice and Specialty Residency (Primary Care with Cardiology Emphasis) training at Advocate Health Care, Lutheran General Hospital and UIC.

Dr. Nutescu’s research interests focus on comparative effectiveness and safety of cardiovascular pharmacotherapy and thromboembolic diseases. She has authored over 180 scientific articles and her research has been continuously funded by the National Institutes of Health, National Heart Lung and Blood Institute, The Department of Health and Human Services, the Agency for Healthcare Research and Quality, and the National Center for Research Resources, among others. She is a recipient of the Ruth L. Kirchstein National Research Service Award and National Heart Lung and Blood Institute Clinical Research Career Development Award. She has lectured extensively, both nationally and internationally, on topics related to personalized medicine, thrombosis, cardiovascular diseases and stroke. Her book, “Anticoagulation Therapy: A Clinical Practice Guide,” is used nationally and internationally to guide clinical practice guidelines and the bedside management of patients on anticoagulation therapy.

Dr. Nutescu serves as Scientific Editor for the journal Pharmacotherapy and has served on the editorial board for the American Journal of Health-System Pharmacy and Annals of Pharmacotherapy. She is active in several professional organizations including the American College of Clinical Pharmacy, the American Heart Association, the International Society for Thrombosis and Haemostasis, Academy Health, the Anticoagulation Forum, and the National Blood Clot Alliance. She has served on the Board of Regents for the American College of Clinical Pharmacy, on the National Consumers League Senior Outpatient Medication Safety Coalition, and was the only pharmacist member to serve on the steering committee of the National Quality Forum and The Joint Commission that developed “National Consensus Standards for the Prevention and Care of Venous Thrombosis.” Dr. Nutescu has been recognized as a Fellow of the American College of Clinical Pharmacy. She has received the American Society of Health System Pharmacists Foundation Award for Excellence in Medication-Use Safety, the American College of Clinical Pharmacy’s Clinical Practice Award, the Russel R. Miller Award for her substantial contributions to the literature of clinical pharmacy, and the Therapeutics Frontiers Award for her outstanding contributions to pharmacotherapeutics in her field.

Statement of Need

Atrial fibrillation (AF) is estimated to affect over 5 million people in the United States and is associated with a five-fold increase in the relative risk of stroke. Obesity is an independent risk factor for cardiovascular disease (CVD) and is also associated with increased risk of developing non-valvular AF (NVAF). Patients with comorbid NVAF and obesity need appropriate management of their individual stroke risk. Guidelines for anticoagulant therapy in this patient population have been limited due to lack of available data.

Recent publications of subgroup analyses of randomized controlled trials (RCTs) and retrospective observation cohort studies have provided data on the efficacy and safety of direct oral anticoagulants (DOACs) versus warfarin in obese and extremely obese patients with NVAF. Because pharmacists are a trusted resource and have frequent access to patients, it is imperative that they are well-versed in the latest published data as well as existing guidelines and prescribing information for use of DOACs and warfarin to prevent stroke in patients with NVAF.

In this CME Outfitters virtual symposium, expert faculty will review key aspects of the prescribing information, guidelines, and recently published safety and efficacy data for DOACs and warfarin in order to enable pharmacists and other clinicians to support evidence-based therapeutic treatment decisions in obese patients with NVAF.

Learning Objectives

At the end of this CME/CE activity, participants should be able to:

  • Assess existing guidelines and U.S. prescribing information for use of DOACs and warfarin to prevent stroke in obese patients with NVAF.
  • Evaluate safety and efficacy data for DOACs and warfarin in obese patients with NVAF.
  • Counsel obese patients with NVAF on risks and benefits of DOACs and warfarin to optimize adherence and health outcomes.

Financial Support

Supported by an educational grant from the Bristol-Myers Squibb and Pfizer Alliance.

Target Audience

Health-system and community pharmacists.

Credit Information

Physicians (ACCME)

CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses (CNE)

Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.0 contact hour(s).

Note to Nurse Practitioners

Nurse Practitioners can apply for AMA PRA Category 1 Credit through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

Pharmacists (ACPE)

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit. Jump to Activity UAN.

Note to PAs

PAs may claim a maximum of .25 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credit  from organizations accredited by ACCME or a recognized state medical society.

MIPS Improvement Activity

This activity counts towards MIPS Improvement Activity requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Bhatt reports that he is a consultant for Abbott; Afimmune; Amarin Corporation; Amgen Inc.; Astra Zeneca; Bayer Corporation; Boehringer Ingelheim; Bristol-Myers Squibb Company; Cardax, Inc.; Chiesi USA, Inc.; CSL Behring; Eisai Inc.; Ethicon USA, LLC; Ferring Pharmaceuticals; Forest Laboratories; Fractyl Laboratories, Inc.; Idorsia Pharmaceuticals Ltd.; Ironwood Pharmaceuticals, Inc.; Ischemix; Lexicon Pharmaceuticals, Inc.; Lilly USA, LLC.; Medtronic; PhaseBio Pharmaceuticals, Inc.; Pfizer Inc.; PLx Pharma Inc.; Regeneron; Roche; Sanofi-Aventis U.S. LLC; Synaptic Pharmaceutical Corp.; and The Medicines Company.

Dr. Kido has no disclosures to report.

Dr. Nutesco has no disclosures to report.

Rachel Speer, PhD (planning committee) has no disclosures to report.

Evan Luberger (planning committee) has no disclosures to report.

Jan Perez (planning committee) has no disclosures to report.

Sharon Tordoff (planning committee) has no disclosures to report.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty has been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Additional Formats

Post-tests, credit request forms, and activity evaluations must be completed online (requires free account activation), and participants can print their certificate or statement of credit immediately (75% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit our Privacy & Confidentiality page.


NOTE: Pharmacist CE Universal Activity Number, Enduring: JA0007185-0000-20-001-H01-P


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Weighing the Evidence: A Pharmacy Approach to Stroke Prevention in Obese Patients with NVAF
Event Date: 06/30/2021