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February 2009 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for February 2009. 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.

Risk Score May Help Predict Atrial Fibrillation

FRIDAY, Feb. 27 (HealthDay News) -- A newly developed risk score based on readily available clinical factors can predict an individual's absolute risk of developing atrial fibrillation, allowing high-risk individuals to be targeted for prevention, according to research published in the Feb. 28 issue of The Lancet.

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Daytime Sleepiness Linked to Risk of Death in Elderly

FRIDAY, Feb. 27 (HealthDay News) -- Older individuals who are excessively sleepy during the day may face a higher risk of mortality, according to research published online Feb. 26 in the journal Stroke.

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Ischemic Strokes Rise Steeply with Age Even in Young

FRIDAY, Feb. 27 (HealthDay News) -- Modifiable risk factors for stroke, such as high cholesterol and hypertension, were common in a group of younger stroke patients, according to research published online Feb. 26 in the journal Stroke.

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Guidelines for Prevention of Rheumatic Fever Updated

FRIDAY, Feb. 27 (HealthDay News) -- Prevention of rheumatic fever relies on proper identification and treatment of the bacteria responsible, with penicillin being the preferred treatment, according to updated guidelines published online Feb. 26 in Circulation: Journal of the American Heart Association.

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Two Types of Stents Get Similar Results

THURSDAY, Feb. 26 (HealthDay News) -- Unprotected left main coronary artery disease can be safely treated with either paclitaxel- or sirolimus-eluting stents, according to the results of a study published online Feb. 25 in the Journal of the American College of Cardiology.

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Antihypertensive Treatment Benefits Dialysis Patients

THURSDAY, Feb. 26 (HealthDay News) -- In dialysis patients, treatment with blood pressure-lowering medications may significantly reduce rates of cardiovascular morbidity and mortality, according to the results of a study published online Feb. 26 in The Lancet.

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Various Diet Compositions Effective for Weight Loss

WEDNESDAY, Feb. 25 (HealthDay News) -- Diets where calories come from a range of fat, protein and carbohydrate combinations are similarly effective in promoting weight loss and reducing cardiovascular risk factors, researchers report in the Feb. 26 issue of the New England Journal of Medicine.

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Osteopontin May Be Heart Risk Factor in Psoriasis Patients

WEDNESDAY, Feb. 25 (HealthDay News) -- Circulating osteopontin -- a glycophosphoprotein secreted by epithelial and many other cell types -- may be a cardiovascular risk factor in individuals with psoriasis, according to research published in the February issue of the Journal of the American Academy of Dermatology.

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More Heart Guidelines Based on Low Levels of Evidence

TUESDAY, Feb. 24 (HealthDay News) -- Many recommendations in guidelines are based on low levels of evidence or expert opinion, according to an article published in the Feb. 25 issue of the Journal of the American Medical Association.

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Insurance Essential for Good Health, Well-Being

TUESDAY, Feb. 24 (HealthDay News) -- Having health insurance is vital for health and well-being, and when rates of uninsurance are high, even insured people are more likely to struggle to obtain necessary care, according to a new report from the Institute of Medicine released online Feb. 24.

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US Health Spending May Have Hit $2.4 Trillion in 2008

TUESDAY, Feb. 24 (HealthDay News) -- Health spending in the United States was estimated to be $2.4 trillion last year, and is expected to account for an unprecedented share of the economy this year, according to a report published online Feb. 24 in Health Affairs.

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Anger Induces Heart Instability and Arrhythmias

TUESDAY, Feb. 24 (HealthDay News) -- Anger-induced T-wave alternans, a marker of repolarization instability, predicts ventricular arrhythmias in patients with implantable cardioverter-defibrillators (ICDs), providing a link between stress and sudden death, according to a report in the Mar. 3 issue of the Journal of the American College of Cardiology.

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Heat Increases Respiratory Hospital Admissions in Elderly

MONDAY, Feb. 23 (HealthDay News) -- Increasing temperatures in Europe in the spring and summer are associated with an increase in hospital admissions for respiratory problems in the elderly, which may become worse with global warming and an aging population, researchers report in the Mar. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Brain Surgery Shows Benefit in Pediatric Stroke Patients

MONDAY, Feb. 23 (HealthDay News) -- Periinsular hemispherotomy may be useful in treating stroke-induced refractory epilepsy in children, according to research published in the February issue of the Journal of Neurosurgery: Pediatrics.

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PCI Shows Benefit in Elderly With MI, Cardiogenic Shock

FRIDAY, Feb. 20 (HealthDay News) -- Among patients with myocardial infarction and cardiogenic shock who underwent percutaneous coronary intervention, elderly patients showed similar one-year survival and other outcomes as younger patients, according to research published in the February Journal of the American College of Cardiology: Cardiovascular Interventions.

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Novel Drug May Benefit Patients With Heart Disease

FRIDAY, Feb. 20 (HealthDay News) -- The investigational drug A-002 may be an effective anti-atherosclerotic agent because it reduces levels of secretory phospholipase A2 (sPLA2) enzymes, plasma lipoproteins, and inflammatory biomarkers, according to a study published in the Feb. 21 issue of The Lancet.

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Healthy Lifestyle Behaviors Lower Risk of Stroke

FRIDAY, Feb. 20 (HealthDay News) -- In middle-aged and older adults, a combination of four healthy lifestyle behaviors may significantly reduce the risk of stroke, according to a study published online Feb. 20 in the British Medical Journal.

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Eltrombopag Increases Platelet Counts in Purpura

FRIDAY, Feb. 20 (HealthDay News) -- In patients with chronic idiopathic thrombocytopenic purpura, eltrombopag -- an oral, non-peptide, thrombopoietin-receptor agonist -- may help manage thrombocytopenia, according to a study published in the Feb. 21 issue of The Lancet.

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High-Dose Candesartan Can Reduce Proteinuria

THURSDAY, Feb. 19 (HealthDay News) -- Extra-high dosages of candesartan may be beneficial in reducing persistent proteinuria, according to research published online Feb. 11 in the Journal of the American Society of Nephrology.

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Combo Blood Pressure-Lowering Regimen Good for Kidneys

THURSDAY, Feb. 19 (HealthDay News) -- A blood pressure-lowering treatment strategy of perindopril-indapamide may prevent renal dysfunction in some patients with type 2 diabetes, regardless of baseline blood pressure level, according to the results of a study published online Feb. 18 in the Journal of the American Society of Nephrology.

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Pressure Test Predicts Heart Disease in Kidney Patients

THURSDAY, Feb. 19 (HealthDay News) -- A pulse pressure test predicts coronary artery calcium and survival in patients with chronic kidney disease, according to research published in the February issue of the Clinical Journal of the American Society of Nephrology.

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Genetic Variants Associated with Blood Pressure Variations

THURSDAY, Feb. 19 (HealthDay News) -- Genetic variants at the NPPA-NPPB locus may influence hypertension due to effects on natriuretic peptide concentrations, according to research published online Feb. 15 in Nature Genetics.

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Proposed Changes to Health Care Would Reduce Costs

THURSDAY, Feb. 19 (HealthDay News) -- Simultaneous gains in universal health coverage, improved health outcomes and slowed spending growth would have a major impact on the development of public policy, according to a perspective published in the Feb. 26 issue of the New England Journal of Medicine.

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PCI After Heart Attack Not Effective Over Long Term

THURSDAY, Feb. 19 (HealthDay News) -- Percutaneous coronary intervention (PCI) is expensive and does not benefit quality of life, only producing a modest short-term benefit in cardiac physical function that is not maintained, according to a report published in the Feb. 19 issue of the New England Journal of Medicine.

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Transparency, Globalization Growing in Clinical Research

THURSDAY, Feb. 19 (HealthDay News) -- All clinical trial data and the U.S. Food and Drug Administration database should be publicly available, and global clinical research should be conducted in relevant populations for potential applications of the intervention, according to two articles published in the Feb. 19 issue of the New England Journal of Medicine.

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Pharmacogenetic Algorithm Improves Warfarin Dosage

WEDNESDAY, Feb. 18 (HealthDay News) -- A pharmacogenetic dosing algorithm for warfarin is better able to predict the stable therapeutic dose, providing a basis for a larger clinical trial to test the efficacy of these algorithms, according to research published in the Feb. 19 issue of the New England Journal of Medicine.

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Coronary Artery Bypass Grafting Best for Certain Patients

WEDNESDAY, Feb. 18 (HealthDay News) -- Coronary artery bypass grafting (CABG), and not percutaneous coronary intervention (PCI), results in lower incidence of cardiac or cerebrovascular events in patients with three-vessel or left main coronary artery disease, and should therefore remain the standard of care, according to research released online Feb. 18 in advance of publication in the Mar. 5 issue of the New England Journal of Medicine.

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Repairing Heart Defect May Relieve Migraines

WEDNESDAY, Feb. 18 (HealthDay News) -- Patent foramen ovale closure can greatly reduce the frequency and severity of migraines, according to study findings published in the February issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Non-Invasive Imaging After Exercise Detects Heart Disease

WEDNESDAY, Feb. 18 (HealthDay News) -- Using strain imaging to quantify regional heart function after treadmill exercise is an effective and non-invasive way to detect coronary artery disease, researchers report in the Feb. 24 issue of the Journal of the American College of Cardiology.

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Treatment Improves Platelet Function During Stenting

WEDNESDAY, Feb. 18 (HealthDay News) -- Treatment with bivalirudin plus eptifibatide reduces platelet reactivity and clot strength in patients undergoing elective stenting, which are associated with the risk of myocardial infarction, according to the results of a study published in the Feb. 24 issue of the Journal of the American College of Cardiology.

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Implementing a Quality Improvement Faculty Path

WEDNESDAY, Feb. 18 (HealthDay News) -- A new career pathway in academic medicine, termed clinicians in quality improvement, is a justified concept to achieve and recognize excellence in patient safety, according to a commentary published in the Feb. 18 issue of the Journal of the American Medical Association.

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Incidence of ICU MRSA Infections Declining

TUESDAY, Feb. 17 (HealthDay News) -- Incidence of methicillin-resistant Staphylococcus aureus (MRSA) central line-associated bloodstream infections has decreased over recent years in most intensive care units (ICUs), according to research published Feb. 18 in the Journal of the American Medical Association.

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Ads Featuring 'Drug Facts Box' Help Educate Consumers

TUESDAY, Feb. 17 (HealthDay News) -- Replacing the brief summary in direct-to-consumer ads with a "drug facts box" may result in improved consumer knowledge and judgment about medication benefits and side effects, according to study findings released online Feb. 17 in advance of publication in the Apr. 21 issue of the Annals of Internal Medicine.

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Sudden Death in Athletes Rare, But Increasing

TUESDAY, Feb. 17 (HealthDay News) -- Sudden death in competitive athletes -- a rare but significant event -- is primarily due to cardiovascular disease, which lends support to the use of cardiovascular screening prior to participation in athletic training, according to research published online Feb. 16 in Circulation: Journal of the American Heart Association.

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Coffee, Mediterranean Diet Linked to Lower Stroke Risk

TUESDAY, Feb. 17 (HealthDay News) -- In women, long-term coffee consumption and adherence to a Mediterranean diet are both associated with a decreased risk of stroke, according to two studies published online Feb. 16 in Circulation: Journal of the American Heart Association.

Abstract - Lopez-Garcia
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Abstract - Fung
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Guidelines for Cholesterol Treatment Cost-Effective

TUESDAY, Feb. 17 (HealthDay News) -- Full implementation of national cholesterol treatment guidelines could have a major health impact at a cost-effective price, according to research published in the Feb. 17 issue of the Annals of Internal Medicine.

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Few Adolescents Need Treatment for Cholesterol

TUESDAY, Feb. 17 (HealthDay News) -- Using national data, less than 1 percent of adolescents are potentially eligible to receive pharmacological treatment for elevated concentrations of low-density lipoprotein (LDL) cholesterol, according to research published online Feb. 16 in Circulation: Journal of the American Heart Association.

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Genetic Research Finds Evidence of Heart-Related Risks

MONDAY, Feb. 16 (HealthDay News) -- Researchers have uncovered a number of genetic factors that may be associated with risk of coronary artery disease or myocardial infarction, according to five studies published online Feb. 8 in Nature Genetics.

Abstract - Erdmann
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Abstract - Tregouet
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Abstract - Ozaki
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Abstract - Gudbjartsson
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Abstract - Myocardial Infarction Genetics Consortium
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Metabolic Syndrome Raises Salt Sensitivity of Blood Pressure

MONDAY, Feb. 16 (HealthDay News) -- Metabolic syndrome is significantly associated with salt sensitivity of blood pressure, according to a report published online Feb. 16 in The Lancet.

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Pauses in CPR Chest Compressions Detrimental

FRIDAY, Feb. 13 (HealthDay News) -- In patients with ventricular fibrillation or tachycardia, the likelihood of return of spontaneous circulation falls steadily as pre-shock pauses in cardiopulmonary resuscitation (CPR) chest compressions grow longer, according to research published Feb. 6 in BMC Medicine.

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Secondhand Smoke Linked to Cognitive Impairment

FRIDAY, Feb. 13 (HealthDay News) -- Secondhand smoke exposure may be associated with an increased risk of developing cognitive impairment, according to research published online Feb. 12 in BMJ.

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Prophylactic Warfarin Doesn't Cut Cancer Patient Thromboses

FRIDAY, Feb. 13 (HealthDay News) -- Treating cancer patients who have central venous catheters with prophylactic warfarin does not reduce the risk of symptomatic catheter-related or other thromboses, according to a report published in the Feb. 14 issue of The Lancet.

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Social Factors Affect Smoke Avoidance in Pregnant Women

THURSDAY, Feb. 12 (HealthDay News) -- In pregnant non-smoking black women, social factors play a significant role in the avoidance of environmental tobacco smoke, according to an article published in the March issue of the American Journal of Preventive Medicine.

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Thrombolysis Window May Be Longer Than Thought

THURSDAY, Feb. 12 (HealthDay News) -- Patients with acute stroke may have a diffusion-perfusion mismatch after nine hours of stroke onset, particularly those with proximal arterial occlusion, suggesting the treatment window for stroke may be extended in some cases, according to the results of a study published in the March issue of Radiology.

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Multislice Imaging Predicts Cardiac Events

THURSDAY, Feb. 12 (HealthDay News) -- Multislice computed tomography (MSCT) coronary angiography independently predicts death and heart attack and provides additional prognostic information over myocardial perfusion imaging in patients with suspected coronary artery disease, researchers report in the Feb. 17 issue of the Journal of the American College of Cardiology.

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Contrast Echocardiography Improves Cardiac Evaluation

THURSDAY, Feb. 12 (HealthDay News) -- Using contrast echocardiography to assess patients' ventricular function significantly reduces the number of procedures, improves the accuracy of drug prescription and improves patient management, according to a report published online Feb. 11 in the Journal of the American College of Cardiology.

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Financial Incentives May Improve Smoking Cessation

WEDNESDAY, Feb. 11 (HealthDay News) -- Offering workers financial incentives to stop smoking was associated with higher long-term smoking cessation rates, according to research published in the Feb. 12 issue of the New England Journal of Medicine.

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Dronedarone May Offer Benefits in Atrial Fibrillation

WEDNESDAY, Feb. 11 (HealthDay News) -- In patients with atrial fibrillation, the use of dronedarone -- which is similar in profile to amiodarone -- was associated with a lower rate of hospitalization for cardiovascular events or death, according to research published in the Feb. 12 issue of the New England Journal of Medicine.

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Stroke Risk in Women Needs More Research

WEDNESDAY, Feb. 11 (HealthDay News) -- Women account for the majority of stroke deaths in the United States, yet there are major gaps in awareness of risk factors specific to women, and in the knowledge of the causes and treatment of strokes in women, according to several reports published a special themed issue of Stroke released online Feb. 10 and dedicated to the epidemic of stroke among women.

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Decreased Mortality Linked to Continued Statin Use

WEDNESDAY, Feb. 11 (HealthDay News) -- Continued use of statins results in an ongoing reduction of all-cause mortality in patients with or without a history of coronary heart disease, researchers report in the Feb. 9 issue of the Archives of Internal Medicine.

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Hospital, Physician Volume Affect PCI Death Risk

WEDNESDAY, Feb. 11 (HealthDay News) -- Patients who undergo primary percutaneous coronary intervention (PCI) have a lower risk of death when the procedure is performed in high-volume hospitals with high-volume experienced physicians, researchers report in the Feb. 17 issue of the Journal of the American College of Cardiology.

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Multivitamins Do Not Lower Risk of Chronic Disease

WEDNESDAY, Feb. 11 (HealthDay News) -- Multivitamins have little to no impact on the risk of cancer, cardiovascular disease or mortality in postmenopausal women, according to study findings published in the Feb. 9 issue of the Archives of Internal Medicine.

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Care Coordination Programs Don't Benefit Medicare Patients

TUESDAY, Feb. 10 (HealthDay News) -- For Medicare beneficiaries with chronic illnesses, most care coordination programs have little impact on reducing hospitalizations and costs or improving quality of care, according to a report published in the Feb. 11 issue of the Journal of the American Medical Association.

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Hypertension Management, Awareness Improving in England

TUESDAY, Feb. 10 (HealthDay News) -- Awareness, treatment and control rates of hypertension improved in England from 2003 to 2006, according to the results of a health survey published online Feb. 9 in Hypertension.

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Mediterranean Diet Benefits Cognitive Function in Elderly

MONDAY, Feb. 9 (HealthDay News) -- In cognitively normal older adults, adherence to a Mediterranean diet is associated with a modestly reduced risk of developing mild cognitive impairment, and in older adults who already have mild cognitive impairment, adherence to the diet is associated with a significantly reduced risk of developing Alzheimer's disease, according to a report published in the February issue of the Archives of Neurology.

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Smoking Stops Cell Growth Via Aging Protein

MONDAY, Feb. 9 (HealthDay News) -- Cigarette smoke stops cell growth and impairs cell migration via a protein involved in premature aging, according to research published in the Feb. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Preoperative Reduction in Smoking is Cost-Beneficial

FRIDAY, Feb. 6 (HealthDay News) -- Preoperative interventions for smoking cessation can result in modest cost savings, which may accumulate with the use of an institution-based smoking cessation program through reduced total hospitalization costs, according to research published in the February issue of Chest.

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Rapid Treatment for Minor Strokes Reduces Hospital Use

FRIDAY, Feb. 6 (HealthDay News) -- Rapid assessment and early treatment of transient ischemic attack (TIA) and minor stroke in a specialty outpatient clinic were associated with less subsequent hospital use and disability, according to research published online Feb. 5 in The Lancet Neurology.

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Exercise, Endovascular Therapy Help Claudication

FRIDAY, Feb. 6 (HealthDay News) -- Treating intermittent claudication with revascularization may offer immediate advantages over a supervised exercise intervention, but the two offer similar benefits after six months, according to research published in the February issue of Radiology.

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Risk of Venous Thrombosis After Spinal Surgery Low

FRIDAY, Feb. 6 (HealthDay News) -- The risk of deep venous thrombosis after spinal surgery is relatively low, and the condition can be prevented by using compression stockings or pneumatic sequential compression devices, according to a review in the Feb. 1 issue of Spine.

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Height Loss Linked to Loss of Lung Function

THURSDAY, Feb. 5 (HealthDay News) -- An increased arm span to height ratio, suggesting a loss of height, is significantly associated with reduced respiratory airflow volumes, increased dyspnea severity, and right heart strain indicative of pulmonary heart disease, according to research published in the February issue of Chest.

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Cardiac Imaging Use Must Consider Risks and Rewards

WEDNESDAY, Feb. 4 (HealthDay News) -- The decision to use cardiac imaging tests should take into account the potential risks of malignancy due to radiation exposure, as well as the benefits of the test, according to an American Heart Association science advisory published online Feb. 2 in Circulation: Journal of the American Heart Association.

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Resting Heart Rate Can Predict Women's Heart Death Risk

WEDNESDAY, Feb. 4 (HealthDay News) -- A low-tech and inexpensive test to measure women's resting heart rate can predict the risk of myocardial infarction and coronary death, according to research published online Feb. 3 in BMJ.

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Diabetes, Heart Disease Raise Coronary Event Risk in HIV

WEDNESDAY, Feb. 4 (HealthDay News) -- Both diabetes mellitus and pre-existing coronary heart disease (CHD) are associated with an increased risk of a CHD event in individuals with HIV, indicating the need for diabetes screening in this population, according to research published online Feb. 2 in Circulation: Journal of the American Heart Association.

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Lower Birth Weight Linked to Smoking During Pregnancy

WEDNESDAY, Feb. 4 (HealthDay News) -- The reduced fetal growth seen in the offspring of maternal smokers may be due in part to lower endothelial nitric oxide synthase (eNOS) activity in fetal umbilical and chorionic vessels, according to research published online Feb. 2 in Circulation: Journal of the American Heart Association.

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Radiation Dose in Angiography Similar to Other Procedures

TUESDAY, Feb. 3 (HealthDay News) -- The radiation dose associated with cardiac computed tomography angiography (CCTA) is comparable to other diagnostic procedures, but varies depending on site and computed tomography system used, according to research published in the Feb. 4 issue of the Journal of the American Medical Association.

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Ventricular Remodeling Extent Linked to Outcomes

TUESDAY, Feb. 3 (HealthDay News) -- Heart failure patients with more extensive left ventricular reverse remodeling after cardiac resynchronization therapy have better outcomes such as improvements in left ventricular function, fewer hospitalizations and reduced mortality, researchers report in the Feb. 10 issue of the Journal of the American College of Cardiology.

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Peptide Hormone Reduces Infarct Size After Heart Attack

TUESDAY, Feb. 3 (HealthDay News) -- A gastrointestinal peptide hormone originally derived from the saliva of a venomous lizard is effective in reducing infarct size and preventing cardiac function deterioration after a heart attack in pigs, according to the results of an animal study published in the Feb. 10 issue of the Journal of the American College of Cardiology.

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Methods Determine If Defibrillator Will Benefit Patient

TUESDAY, Feb. 3 (HealthDay News) -- Non-invasive microvolt T-wave alternans (MTWA) and electrophysiological study (EPS) are effective in identifying patients with cardiac disease who may benefit from an implantable cardioverter-defibrillator, according to a report in the Feb. 10 issue of the Journal of the American College of Cardiology.

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Muscle Problems Among Many Possible Statin Effects

MONDAY, Feb. 2 (HealthDay News) -- Mitochondrial factors may play a role in the muscle-related complaints associated with the use of statin drugs, as well as many other adverse effects, according to a review published in December in the American Journal of Cardiovascular Drugs.

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Physician's Briefing
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