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December 2007 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for December 2007. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Reduced Alzheimer's Risk with NSAIDs Depends on Genetics

MONDAY, Dec. 31 (HealthDay News) -- Elderly individuals who take non-steroidal anti-inflammatory drugs (NSAIDs) have a lower risk of developing dementia and Alzheimer's disease, although the reduction for Alzheimer's is found only in individuals with a particular genetic background, researchers report in the Jan. 1 issue of Neurology.

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Selective Thyromimetic Lowers LDL Cholesterol

FRIDAY, Dec. 28 (HealthDay News) -- Treatment with a synthetic, selective thyromimetic improves dyslipidemia without apparent cardiac side effects related to thyroid hormone, according to a report published online Dec. 26 in the Proceedings of the National Academy of Sciences Early Edition.

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Distinct Arterial Remodeling in Young Patients with AMI

THURSDAY, Dec. 27 (HealthDay News) -- Younger Japanese patients with acute myocardial infarction (AMI) were more likely to have a constrictive type of arterial remodeling as the culprit atherosclerotic lesion than middle-aged and older patients, researchers report in the Dec. 15 issue of the American Journal of Cardiology.

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Telmisartan Combined with Ramipril Curbs Strokes in Rats

THURSDAY, Dec. 27 (HealthDay News) -- Combined doses of telmisartan and ramipril are effective at preventing strokes and lowering blood pressure in stroke-prone rats, researchers report in the November-December issue of the Journal of the American Society of Hypertension.

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Catheter Ablation Reduces Defibrillator Shock Frequency

WEDNESDAY, Dec. 26 (HealthDay News) -- Ablation of arrhythmic cardiac tissue combined with an implantable cardioverter-defibrillator (ICD) reduces the frequency of pacing and shocks better than an ICD alone in patients with a history of myocardial infarction, according to study findings published in the Dec. 27 issue of the New England Journal of Medicine.

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Adverse Events with Platelet Drop in Coronary Syndromes

WEDNESDAY, Dec. 26 (HealthDay News) -- Patients with non-ST-elevation acute coronary syndromes have a higher risk of adverse outcomes such as death or heart attack if they develop thrombocytopenia, according to the results of a study in the Dec. 15 issue of the American Journal of Cardiology.

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Previously Uninsured Enjoy Better Health with Medicare

WEDNESDAY, Dec. 26 (HealthDay News) -- The health of people who don't have health insurance improves once they acquire Medicare coverage at the age of 65, especially if they have cardiovascular disease or diabetes, researchers report in the Dec. 26 issue of the Journal of the American Medical Association.

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Neonatal Heart Can Grow After Valve Surgery

FRIDAY, Dec. 21 (HealthDay News) -- In neonates who underwent surgery for aortic valve stenosis, some left heart structures can eventually reach normal size, according to the results of a study published in the Dec. 18/25 issue of the Journal of the American College of Cardiology.

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Maximum Heart Rate Lower During Sex Than Exercise

THURSDAY, Dec. 20 (HealthDay News) -- Sexual activity results in a lower maximum heart rate and blood pressure than treadmill exercise in adult men and women, according to study findings published in the Dec. 15 issue of the American Journal of Cardiology.

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Cardiovascular Disease to Cost $449 Billion in 2008

THURSDAY, Dec. 20 (HealthDay News) -- Although death rates from cardiovascular disease fell nearly 25 percent between 1994 and 2004, it remains the leading cause of death in the United States, killing an American every 37 seconds, according to the American Heart Association's 2008 heart disease and stroke statistics update, published online Dec. 17 in Circulation: Journal of the American Heart Association.

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Pioglitazone May Reduce Risks of Chronic Kidney Disease

THURSDAY, Dec. 20 (HealthDay News) -- Patients with chronic kidney disease are at greater risk of serious cardiovascular complications, and some of these risks can be reduced by treatment with pioglitazone, according to a study published online Dec. 5 in the Journal of the American Society of Nephrology.

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Aldosterone Mediators of Cardiac Injury Identified

THURSDAY, Dec. 20 (HealthDay News) -- The ability of aldosterone to generate superoxide and cause cardiovascular injury is mediated by several cellular mediators including NAD(P)H oxidase and Rac1, according to a study published online Dec. 13 in Endocrinology.

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More Use of BNP Test in Heart Patients May Be Warranted

WEDNESDAY, Dec. 19 (HealthDay News) -- In a national sample, B-type natriuretic peptide (BNP) levels were measured in only one-fifth of patients with non-ST-segment-elevation acute coronary syndromes (NSTE ACS), even though elevated levels are associated with higher mortality risk in these patients, according to research published in the Dec. 15 issue of the American Journal of Cardiology.

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Caution Urged in Screening for Carotid Artery Stenosis

WEDNESDAY, Dec. 19 (HealthDay News) -- The number of strokes that would be avoided by screening asymptomatic individuals for carotid artery stenosis and treatment with carotid endarterectomy is too low to justify the potential risks, researchers report in the Dec. 18 issue of the Annals of Internal Medicine.

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False-Positive Cardiac Cath Lab Activations Common

TUESDAY, Dec. 18 (HealthDay News) -- Between 9 to 14 percent of all cardiac catheterization laboratory activations in a regional ST-segment elevation myocardial infarction (STEMI) network are false positives, where no culprit coronary lesion is identified and/or cardiac biomarkers are negative, according to research published in the Dec. 19 issue of the Journal of the American Medical Association.

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FDA Approves New Beta Blocker for Hypertension

TUESDAY, Dec. 18 (HealthDay News) -- The U.S. Food and Drug Administration announced this week that it has approved Bystolic (nebivolol) for the treatment of hypertension. Bystolic is a beta blocker, a class of commonly prescribed antihypertensive medications that reduce the force of the heart's contraction.

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Drug-Eluting Stents' Benefits Appear to Outweigh Risks

TUESDAY, Dec. 18 (HealthDay News) -- Evidence suggests that the net benefit of drug-eluting stents in relieving obstructive coronary artery disease exceeds the risks of stent thrombosis, according to the authors of a perspective paper published online Dec. 18 in the Annals of Internal Medicine.

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Telomerase Activity High in Plaque Neutrophils in Angina

MONDAY, Dec. 17 (HealthDay News) -- The activity of telomerase, which regulates cell aging, is significantly higher in coronary plaque neutrophils than circulating neutrophils in patients with unstable angina, according to study findings published in the Dec. 18/25 issue of the Journal of the American College of Cardiology.

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Imaging Accuracy for Stenoses Unaffected by Heart Rate

MONDAY, Dec. 17 (HealthDay News) -- Heart rate has no significant effect on the accuracy of dual-source computed tomography (DSCT) coronary angiography in diagnosing coronary artery stenosis, researchers report in the Dec. 18/25 issue of the Journal of the American College of Cardiology.

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Exercise Improves Metabolic Syndrome in Obese Adults

MONDAY, Dec. 17 (HealthDay News) -- Moderate-intensity exercise for 170 minutes a week -- the equivalent of walking about 12 miles -- can significantly improve metabolic syndrome, which supports the amount that major exercise guidelines recommend, according to research published in the Dec. 15 issue of the American Journal of Cardiology.

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Guidelines for ST-Elevation Myocardial Infarction Updated

MONDAY, Dec. 17 (HealthDay News) -- Managing patients with acute ST-elevation myocardial infarction should not only be about drugs and devices, but also emphasize an integrated team system of care, according to updated guidelines published online Dec. 10 in Circulation: Journal of the American Heart Association.

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Pergolide Increases Valve Disease Risk in Parkinson's

MONDAY, Dec. 17 (HealthDay News) -- Treating patients with Parkinson's disease with pergolide, a dopamine receptor agonist, increases the risk of moderate to severe heart valve disease in a dose-dependent manner, researchers report in the December issue of the Archives of Neurology.

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Cancer Drug Linked to Cardiac Toxicity

FRIDAY, Dec. 14 (HealthDay News) -- Sunitinib can lead to cardiac toxicity, such as heart failure, hypertension and reductions in left ventricular ejection fraction, when used to treat cancer patients, researchers report in the Dec. 15 issue of The Lancet.

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FDA: Lovastatin Should Remain a Prescription Medication

FRIDAY, Dec. 14 (HealthDay News) -- By a 10-2 vote with one abstention, a joint U.S. Food and Drug Administration (FDA) Nonprescription Drugs and Endocrinologic and Metabolic Advisory Committee recommended Dec. 13 against accepting Merck & Co.'s proposal to switch its cholesterol-lowering drug lovastatin (Mevacor) from a prescription to an over-the-counter (OTC) medication. It's the third time that an FDA committee has turned down Merck's OTC-switch application for lovastatin.

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Pig Study Shows Vasopressin's Effect on Blood Flow

FRIDAY, Dec. 14 (HealthDay News) -- The use of low-dose vasopressin in a pig model of septic shock caused substantial redistribution of splanchnic regional and microcirculatory blood flow, resulting in significantly lower total liver blood flow and a marked decrease in microcirculatory blood flow in the pancreas, according to research published in the December issue of Critical Care.

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Predictors of Hemorrhagic Stroke Explored

THURSDAY, Dec. 13 (HealthDay News) -- In patients who have had a recent stroke or transient ischemic attack, treatment with atorvastatin, hemorrhagic stroke as an entry event, male sex, increased age and stage 2 hypertension may be associated with an increased risk of subsequent hemorrhagic stroke, according to study findings published online Dec. 12 in Neurology.

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Low-Weight Heparin Reduces Bleeding in Coronary Surgery

THURSDAY, Dec. 13 (HealthDay News) -- Low-molecular-weight heparin (LMWH) significantly reduces major bleeding better than unfractionated heparin (UFH) in patients undergoing percutaneous coronary intervention without affecting the risk of ischemic complications such as death or heart attack, according to a report in the Dec. 10/24 issue of the Archives of Internal Medicine.

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Less QT Prolongation with Buprenorphine for Addiction

THURSDAY, Dec. 13 (HealthDay News) -- In contrast to levomethadyl and methadone, buprenorphine is much less likely to prolong the QT interval and may be a safer alternative to treat opioid addition, researchers report in the Dec. 10/24 issue of the Archives of Internal Medicine.

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Resynchronization Studied in Narrow QRS Heart Failure

WEDNESDAY, Dec. 12 (HealthDay News) -- Cardiac-resynchronization therapy (CRT), previously shown to improve outcomes in heart failure patients with prolonged QRS interval, does not improve oxygen consumption in patients with moderate-to-severe heart failure and narrow QRS complexes, reports an article published in the Dec. 13 issue of the New England Journal of Medicine.

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Insulin Response Improved in Heart Cell Study

WEDNESDAY, Dec. 12 (HealthDay News) -- Ciglitazone and 9-cis retinoic acid (RA), which are agonists of the nuclear receptor complex PPARγ/RXR, increased insulin- and metabolic stress-stimulated glucose transport in rat cardiomyocytes, according to a report published online Dec. 6 in the journal Endocrinology.

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Thiazolidinediones Linked to Mortality in Older Diabetics

TUESDAY, Dec. 11 (HealthDay News) -- A heightened risk of congestive heart failure, acute myocardial infarction and death has been found among older diabetic patients who are treated with thiazolidinediones (TZDs), according to the results of a study published in the Dec. 12 issue of the Journal of the American Medical Association.

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Hypertension Increases Risk of Mild Cognitive Impairment

TUESDAY, Dec. 11 (HealthDay News) -- Elderly individuals with a history of hypertension are at greater risk of developing mild cognitive impairment, particularly the non-amnestic type, according to the results of a study published in the December issue of the Archives of Neurology.

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Bystander CPR Improves Survival in Cardiac Arrests

TUESDAY, Dec. 11 (HealthDay News) -- Chances of surviving cardiac arrests are enhanced when bystanders initiate either conventional cardiopulmonary resuscitation (CPR) or cardiac-only resuscitation, researchers report in the December 18/25 issue of Circulation: Journal of the American Heart Association.

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FDA: No Increased Heart Risk with Prilosec or Nexium

TUESDAY, Dec. 11 (HealthDay News) -- The U.S. Food and Drug Administration announced this week that a comprehensive review of safety data on the gastroesophageal reflux drugs Prilosec (omeprazole) and Nexium (esomeprazole) did not find an increased risk of cardiovascular events associated with long-term use.

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Blood Pressure Linked to Physical Activity in Children

TUESDAY, Dec. 11 (HealthDay News) -- Children who are more physically active have lower blood pressures, according to the results of a study published online Dec. 10 in Hypertension.

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Waist-Hip Ratio Predicts Heart Disease Better Than BMI

MONDAY, Dec. 10 (HealthDay News) -- Waist-hip ratio is a better predictor of coronary heart disease than body mass index (BMI) in men and women, according to a report in the December 18/25 issue of Circulation: Journal of the American Heart Association.

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Coronary Calcium Increases Cardiovascular Risk in Women

MONDAY, Dec. 10 (HealthDay News) -- Women with any coronary artery calcium are at modestly increased risk of coronary heart disease and cardiovascular events, and women with advanced coronary artery calcium are at even higher risk, according to a report in the Dec. 10/24 issue of the Archives of Internal Medicine.

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Hypertension Is a Major Cardiovascular Comorbidity

MONDAY, Dec. 10 (HealthDay News) -- Among adult patients with cardiovascular comorbidities, nearly three-fourths have hypertension, and in many cases their hypertension is inadequately controlled despite treatment, researchers report in the Dec. 10/24 issue of the Archives of Internal Medicine.

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Mediterranean Diet Linked to Reduced Risk of Death

MONDAY, Dec. 10 (HealthDay News) -- Following a Mediterranean-style diet is associated with a lower risk of mortality, including risk of death from cancer and cardiovascular disease, according to the results of a large study published in the Dec. 10/24 issue of the Archives of Internal Medicine.

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Transfusions During Surgery Increase Risk of Infection

MONDAY, Dec. 10 (HealthDay News) -- Women undergoing cardiac surgery are more likely to receive blood transfusions than men, which may increase their risk of infection and may explain the higher mortality rates among women after surgery, researchers report in the December issue of the Journal of Women's Health.

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Worldwide Burden of Chronic Disease Targeted

THURSDAY, Dec. 6 (HealthDay News) -- Experts address the worldwide chronic disease epidemic in a series of articles published online Dec. 5 in The Lancet. The authors review the burden of chronic disease in developing countries and discuss cost-effective strategies to mitigate this burden in keeping with the World Health Organization's (WHO) global goal of reducing chronic disease mortality by 2 percent over the next decade.

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Embryonic Heart Cells Protect Mice from Arrhythmias

THURSDAY, Dec. 6 (HealthDay News) -- Transplanting embryonic cardiomyocytes into mice who have had a heart attack protects them against ventricular arrhythmias by enhancing intercellular electrical coupling within the engrafted infarct, according to a report in the Dec. 6 issue of Nature.

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Tesamorelin Associated with Reduction in Visceral Fat

WEDNESDAY, Dec. 5 (HealthDay News) -- The growth hormone-releasing factor tesamorelin may be helpful in reducing visceral fat and improving lipid profiles in patients with HIV who are receiving antiretroviral therapy, according to research published in the Dec. 6 issue of the New England Journal of Medicine.

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Obese Youths at Higher Risk of Future Heart Disease

WEDNESDAY, Dec. 5 (HealthDay News) -- Children with a high body mass index (BMI) are at an increased risk of coronary heart disease in adulthood, according to a study published in the December issue of the New England Journal of Medicine. A second study estimates future morbidity based on current obesity trends in teens.

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Scaled-Up Drug Treatment Could Prevent Deaths

WEDNESDAY, Dec. 5 (HealthDay News) -- Scaling up treatment of individuals at high risk for cardiovascular disease with an evidenced-based, multidrug regimen would reduce deaths from cardiovascular disease in 23 countries by almost 18 million over a decade, at an average annual cost of only about $1 per person, according to an article published online Dec. 5 in The Lancet.

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Simple Strategies Could Cut Chronic Disease Deaths

WEDNESDAY, Dec. 5 (HealthDay News) -- Reducing individuals' salt intake by 15 percent and enacting four tobacco control measures could have a substantial impact on mortality from chronic disease in 23 developing countries at a very modest economic cost, researchers report in an article published online Dec. 5 in The Lancet.

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No Ideal Drug Regimen for Acute Coronary Syndromes

TUESDAY, Dec. 4 (HealthDay News) -- Patients on different regimens to treat moderate- and high-risk acute coronary syndromes have similar outcomes in terms of composite ischemia and mortality, according to research published in the Dec. 5 issue of the Journal of the American Medical Association. Deferring administration of glycoprotein IIb/IIIa inhibitors made no difference in ischemia and mortality rates for those undergoing percutaneous coronary intervention, and resulted in a significant reduction in major bleeding at 30 days.

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Measures Stratify Mortality Risk for Heart Attack Patients

TUESDAY, Dec. 4 (HealthDay News) -- Measures of autonomic tone and cardiac electrical substrate can identify patients at high risk of death after myocardial infarction, according to two studies published in the Dec. 11 issue of the Journal of the American College of Cardiology.

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U.S. Task Force Stands by Hypertension Recommendation

TUESDAY, Dec. 4 (HealthDay News) -- Following a literature search on the benefits and harms of screening for hypertension in adults and the harms of early treatment, the U.S. Preventive Services Task Force (USPSTF) found no reason to change its 2003 recommendation that supported screening. The research is published in the Dec. 4 issue of the Annals of Internal Medicine.

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Three Meds Linked to Many Adverse Drug Events in Elderly

TUESDAY, Dec. 4 (HealthDay News) -- Of the adverse drug events among older adults treated in U.S. emergency departments over a recent two-year period, relatively few involved drugs found on a commonly used list of medications deemed potentially inappropriate for older adults, according to study findings published in the Dec. 4 issue of the Annals of Internal Medicine.

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Statin-Induced Muscle Breakdown Linked to Gene

MONDAY, Dec. 3 (HealthDay News) -- Lovastatin-induced muscle fiber breakdown, a side effect of therapy, is associated with induction of the atrogin-1 gene that may be a critical mediator of damage, according to a study in the December issue of the Journal of Clinical Investigation.

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