REGISTER NOW

 

$90
Early Bird Rate, until Friday, Feb. 21, 2020

$125
Late Registration


Full-day program, breakfast, lunch and refreshments included.

5.5 credit hours

For more information,

contact:

Gillian Brunier at:
Gillian.Brunier@SRI.Utoronto.ca

Managing the Complex Patient:
Diagnosis, 
Treatment, and Follow-Up

 

Saturday, April 4, 2020

8:00 a.m. – 3:30 p.m. 
Chestnut Residence & Conference Centre
89 Chestnut Street
Toronto, Ontario, Canada

 

We are pleased to host the second annual Circulate C-CHANGE Conference. This interactive and practical program is designed for family physicians, specialists, nurse practitioners, pharmacists, and other primary care practitioners with an interest in cardiovascular disease prevention and management.

This year’s conference is devoted to covering the C-CHANGE Guidelines, with updates from Hypertension, Obesity, and Cardiac Rehabilitation and the latest clinical trial results and challenges facing the care of multi-morbidity patients with complex conditions with a focus on heart failure. This meeting brings together a multidisciplinary faculty of primary care and specialty experts with an opportunity for participants to discuss management and implementation of the C-CHANGE guidelines for improved patient care.

 

Highlights Include approaches to:

  • Management of heart failure including HFpEF and HFrEF

  • Anticoagulation for Atrial fibrillation in the complex patient with CKD

  • Cardiovascular risk assessment

  • Medical and non-medical management of dysglycemia and dyslipidemia

  • Newest recommendations from Diabetes Canada, Hypertension Canada, Obesity Canada, Stroke Network, and the Canadian Association of Cardiac Prevention and Rehabilitation

  • New and emerging therapies for heart failure

  • Kidney disease in diabetes; management and prevention
     

 

CO-CHAIRS:
 

Dr. Sheldon Tobe, MD, MScCH (HPTE), FRCPC, FACP, FAHA

Nephrologist, Division of Nephrology, Sunnybrook Health Sciences Centre

Professor of Medicine, University of Toronto, Northern Ontario School of Medicine

Nephrologist Sunnybrook Health Sciences Centre

Dr Rahul Jain, MD, CCFP, MScCH (HPTE)

Family Physician and Hospitalist, Sunnybrook Health Sciences Centre
Assistant Professor, University of Toronto, Department of Family and Community Medicine 
 

PROGRAM SPEAKERS/FACILITATORS:
 

Lisa Dubrofsky, MDCM, FRCPC, FAHA

Clinical Associate, Division of Nephrology, Sunnybrook Health Sciences Centre

Richard Choi, MD, FRCPC

Staff Cardiologist at Unity Health Toronto

Michael Heffernan, MD, PhD, FRCPC, FACC

Director, Oakville Cardiologists Inc.
Staff Cardiologist, Oakville Trafalgar Memorial Hospital
Director, Heart Function Clinic, Oakville Trafalgar Memorial Hospital
Assistant Clinical Professor (adj), McMaster University

Peter Liu, MD, FRCPC

Chief Scientific Officer/ Vice President, Research, University of Ottawa Heart Institute
Director, Cardiac Function Laboratory, University of Ottawa Heart Institute
Professor, Faculty of Medicine, University of Ottawa
Professor, Faculty of Medicine, University of Toronto

Robert Myers, MD, FRCPC

Cardiologist, Division of Cardiology, Sunnybrook Health Sciences Centre 
Assistant Professor, Department of Medicine, University of Toronto
Director of the Rapid Cardiology Assessment Clinic, Sunnybrook Health Sciences Centre

Paul Oh, MD, FRCPC

Scientist, Toronto Rehabilitation Institute (TRI)
Associate Professor, Department of Medicine, University of Toronto 
Medical Director, Cardiovascular Prevention and Rehabilitation Program
Research Division Head, Toronto Rehabilitation Institute (TRI)

Sol Stern, MD, MSc, MCFP

Family Physician, Argus Medical Centre
Oakville, Ontario

Subodh Verma, MD, PhD, FRCSC, FAHA

Professor and Cardiac Surgeon, University of Toronto
CRC Chair in CV Surgery, St. Michael's Hospital

PROGRAM OBJECTIVES:

At the conclusion of this program, participants will be able to:
 

  1. Apply the C-CHANGE Guidelines in their practice for improved patient care.
     

  2. Determine appropriate laboratory tests for the screening and management of patients with heart failure.
     

  3. Summarize the newest and emerging therapies and how they apply to renal and cardiovascular protection.

AGENDA

 


 

Plenary Sessions: Include 10 minutes for Q&A
SESSION DESCRIPTIONS

 

* FORMAT: Each of the sessions are led by a trained facilitator. Sessions are 60-minute case-based interactive small group workshops (45 minutes of presentation with discussion questions embedded throughout the case module to stimulate discussion of case presentation, labs, history, practice and data points; 15 minutes after for topic related Q & A). 

 

CC 01, CC 04:
CV Risk Reduction in Diabetes – Initiating and Monitoring Therapy for Patients

Upon completion of this case study, participants should be able to:

  • Describe the patient who should be treated with an SGLT2i or GLP-1 RA.

  • Explain the rational for this treatment and the potential benefits.

  • Describe the steps for initiating and monitoring therapy for patients with diabetes.

CC 02:

Blood Pressure Management: Diagnosis, Treatment and Follow Up

Upon completion of this case study, participants should be able to:

  • To describe the new Hypertension Canada recommendations and algorithm for the diagnosis of hypertension.

  • To outline the rationale for and the methods for using automated office blood pressure measurements.

  • Define White Coat Hypertension, Masked Hypertension, and Masked Uncontrolled Hypertension (MUCH).

  • To describe tools for helping learners acquire and teach the knowledge and skills for blood pressure measurement.

CC 03:

Update on Renal Protection in Patients with Kidney Disease from Diabetes

Upon completion of this case study, participants should be able to:

  • Plan the investigation of patients with hypertension and diabetes, including evaluation for nephropathy.

  • Implement treatment for blood pressure control including blockade of the RAAS .

  • Assess and further manage cardiovascular and renal risk with an SGLT2i and/or GLP-1 RA.

CC 05:

CHF and Hypertension: Management of Hypertension to Prevent Heart Failure and Atrial Fibrillation

Upon completion of this case study, participants should be able to:

  • Apply the Hypertension Canada clinical practice guidelines for hypertension management with heart failure.

  • Explain the relationship between hypertension and heart failure, and in relation to a specific case.

  • Explain the relationship between hypertension and atrial fibrillation, and in relation to a specific case.

CC 06:

The C-CHANGE HF Recommendation for Patients with HFrEF:
How to introduce and manage an ‘ARNI’

Upon completion of this case study, participants should be able to:

  • Identify a patient with reduced ejection fraction heart failure with an indication for an ARNI.

  • Explain to a patient the mechanism and benefit of this therapy in addition to usual standard of care for HF.

  • Describe the steps for initiating and monitoring therapy for patients with reduced EF heart failure.

 

CC 07:

Anticoagulation for Non-valvular Atrial Fibrillation in the Complex Patient with CKD

Upon completion of this case study, participants should be able to:

  • Describe the stages of chronic kidney disease and the prevalence of atrial fibrillation.

  • Explain the relationship for outcomes between atrial fibrillation and chronic kidney disease.

  • Describe the role of direct oral anticoagulants or warfarin for patients with non-valvular AF and CKD.

CC 08:

Management of Patients with Diabetes and Hypertension

Upon completion of this case study, participants should be able to:

  • Plan the investigation of patients with hypertension and diabetes including evaluation for nephropathy.

  • Assess the risk associated with diabetes in patients with hypertension including the impact of diabetic nephropathy.

  • Demonstrate knowledge of the blood pressure target in patients with hypertension living with diabetes.

CC 09:

How C-CHANGE can help Clinicians Manage the Multi Co-morbidity Patient 

Upon completion of this case study, participants should be able to:

  • Identify recommendations for multiple morbidities from the C-CHANGE guidelines.

  • Implement recommendations for multiple morbidities in a single patient.

  • Use the C-CHANGE recommendations to help keep the elderly living at home longer and healthier.

PLENARY TALK OBJECTIVES:

Appropriate Follow Up and Lab Testing for Patients with HFrEF and HFpEF
Upon completion, participants should be able to:

  • Describe the epidemiology of HFrEF and HFpEF and the relationship with hypertension.

  • Explain the natural history of HFrEF and HFpEF and the impact of traditional therapy with beta blockers, RAAS inhibitors, mineralocorticoid receptor antagonists, SGLT2i’s, and ARNI’s.

  • Describe the ideal ambulatory management of patients with HFrEF and HFpEF and the lab and imaging studies recommended after discharge. 

Approach to Atrial Fibrillation in Heart Failure
Upon completion, participants should be able to:

  • Describe the epidemiology and natural history of atrial fibrillation in heart failure.

  • Formulate a management plan for patients with heart failure and atrial fibrillation.

  • Describe a diagnostic testing regimen to assist with surveillance.

The New CACPR Guidelines - Health Behaviors, Change and Beyond
Upon completion, participants should be able to:

  • Explain the impact of cardiac rehab on patient outcomes after a cardiac event.

  • Describe the process for the CACPR clinical practice guideline.

  • Describe the highlights of the new CACPR clinical practice guideline. 

   
SGLT2 Inhibition in the Prevention and Treatment of Heart Failure
Upon completion, participants should be able to:

  • List the clinical trials that have evaluated prevention and treatment of heart failure in people with diabetes and those without diabetes with SGLT2 inhibitors.

  • Describe the clinical implications and practice guidelines supporting these clinical trial observations.

  • Appreciate the mechanism of the heart failure benefit with SLGT2 inhibitors.
     

 

For more information, contact:

Gillian Brunier at:
Gillian.Brunier@SRI.Utoronto.ca

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