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Pharmacodynamic Effects of Vorapaxar in Patients With and Without Diabetes Mellitus: Results of the OPTIMUS-5 Study (JACC: Basic to Translational Science November 2019)

Vorapaxar reduces thrombotic cardiovascular events at the expense of increased bleeding. However, the differential pharmacodynamic (PD) effects of vorapaxar according to diabetes mellitus (DM) status are unknown. Moreover, although withdrawal of aspirin has emerged as a bleeding reduction strategy, the PD effects of stopping aspirin in patients treated with vorapaxar also are unknown. In this prospective PD investigation, vorapaxar was associated with reduced platelet-mediated thrombogenicity without affecting clot kinetics irrespective of DM status. However, platelet-mediated thrombogenicity increased after aspirin withdrawal, particularly among patients with DM.


Douglas L. Mann, MD, FACC

CME Editor
L. Kristin Newby, MD, FACC

Amanda Coniglio, MD

CME Information

Target Audience
JACC Journal CME/MOC/ECME is intended for physicians who treat patients with cardiovascular disease.

Important Dates
Date of Release: November 25, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: November 24, 2020

Learner Objectives
After reading this article the reader should be able to:

  • Compare the mechanism of action of various antiplatelet agents used for the management of acute coronary syndromes.
  • Identify the indications and contraindications for antiplatelet agents used in acute coronary syndromes.
  • Discuss the benefits and risks of preventative aspirin in patients with diabetes mellitus.

Method of Participation and Claiming Credit
This ACCF JACC Journals CME/MOC/ECME activity includes the reading of an article published in one of the JACC journals and the successful completion of self-assessment questions.  

Requesting AMA PRA Category 1 CME Credit™ and/or MOC or ECME credit for this Activity
To request credit, you must:

  • Read the article for which you wish to receive credit.
  • Answer the self-assessment questions. You need to have achieved a passing score of 70% or better in order for the Evaluation link to become activated. If you did not achieve a passing score, please click on the Posttest link in the left navigation bar and retake the exam.
  • After you complete the Evaluation, click on the Claim Credit button in the left navigation bar.
  • For CME or COP credit, enter the total amount of time you actually spent in the activity in the box provided. Please note that you may only claim once for this activity. Click Claim
  • For MOC credit, click the Claim button in the row for MOC. Please note that you may only claim once for this activity. Confirm your ABIM number and date of birth.
  • For ECME credit, click the Claim button in the row for ECME.  Please note that you may only claim once for this activity.  Enter date of birth and click Submit.  
  • The page will be updated with the date and time that you claimed your credit.
  • To view your credit, or to print a certificate, please go to and navigate to the My Transcript section of My ACC.

This CME/MOC/ECME-certified activity may contain links to other educational resources such as clinical trial summaries, journal articles, guidelines, etc., that may not be CME/MOC/ECME certified. Please note that clicking on the links provided to view these resources will open new windows, which are outside of this CME/MOC/ECME-certified activity.

Availability: On-Demand
Available Nov 25, 2019 to Nov 24, 2020
Cost: FREE
Credit Offered: 1 CME Credit
1 ECME Credit
1 ABIM-MOC Point
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