January 2009 Briefing - Cardiology

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

US Outpatient Surgeries Increasingly Common

FRIDAY, Jan. 30 (HealthDay News) -- Outpatient surgery visits are rising in the United States, with the number increasing from 20.8 million in 1996 to 34.7 million in 2006. They now account for nearly two-thirds of all surgery visits compared to about half of all surgery visits in 1996, according to a report issued Jan. 28 by the U.S. Centers for Disease Control and Prevention.

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In-Flight Medical Emergencies Poorly Documented

FRIDAY, Jan. 30 (HealthDay News) -- Despite the fact that the airline industry is nationally and internationally regulated, there is no standardized documentation of in-flight medical emergencies, according to a report published Jan. 20 in the open access journal Critical Care.

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FX06 Cuts Percutaneous Coronary Intervention Injury

THURSDAY, Jan. 29 (HealthDay News) -- In patients undergoing percutaneous coronary intervention to treat acute ST-segment elevation myocardial infarction (STEMI), using intravenous FX06, a fibrin-derived naturally occurring peptide, significantly reduces the necrotic core zone, but does not change scar size or troponin I levels, according to study findings published online Jan. 28 in the Journal of the American College of Cardiology.

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Effects of Cardiovascular Drug Torcetrapib Explored

THURSDAY, Jan. 29 (HealthDay News) -- Torcetrapib, a cardiovascular drug that failed the phase 3 trial ILLUMINATE because of increased mortality, has other molecular targets in addition to cholesteryl ester transfer protein (CETP), according to research published online Jan. 22 in Endocrinology.

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Arterial Stiffness Predicts Hypertension Drug Response

THURSDAY, Jan. 29 (HealthDay News) -- Patients with hypertension and high levels of arterial stiffness are less likely to respond to antihypertensive drugs, researchers report in the Feb. 3 issue of the Journal of the American College of Cardiology.

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Clopidogrel/Proton Pump Inhibitor Combo Questioned

WEDNESDAY, Jan. 28 (HealthDay News) -- Heart attack patients who take both clopidogrel and a proton pump inhibitor other than pantoprazole have an increased risk of reinfarction and may lose the beneficial effects of clopidogrel, according to research published online Jan. 28 in CMAJ, the Canadian Medical Association Journal.

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Glucose Control Important for Acute Coronary Syndrome

WEDNESDAY, Jan. 28 (HealthDay News) -- Cardiologists should be aware of the link between admission hyperglycemia and increased mortality in patients with acute coronary syndrome, according to an article published Feb. 3 in a supplement to the Journal of the American College of Cardiology devoted to glucose issues.

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Faster Response Linked to Improved Cardiac Survival

WEDNESDAY, Jan. 28 (HealthDay News) -- During a recent period, improvements in the "chain of survival" were linked to increased survival following out-of-hospital cardiac arrests in a region of Japan, according to research published online Jan. 26 in Circulation: Journal of the American Heart Association.

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BNP Levels Not a Superior Guide for Heart Failure Therapy

TUESDAY, Jan. 27 (HealthDay News) -- Using N-terminal brain natriuretic peptide (BNP) levels to guide heart failure therapy does not improve overall clinical outcomes or patient quality of life compared to using symptoms to guide treatment, according to a report published in the Jan. 28 issue of the Journal of the American Medical Association.

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Good Survival Post-Cardiac Arrest After Angiography

TUESDAY, Jan. 27 (HealthDay News) -- Patients who are resuscitated after a heart attack have good survival and neurological recovery after undergoing emergent angiography and revascularization, particularly if they are alert post-resuscitation, according to a report in the Feb. 3 issue of the Journal of the American College of Cardiology.

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AHA Supports Omega-6 for Possible Heart Protection

TUESDAY, Jan. 27 (HealthDay News) -- The American Heart Association recommends that at least 5 to 10 percent of individuals' calories should come from omega-6 polyunsaturated fatty acids, according to a science advisory published online Jan. 26 in Circulation: Journal of the American Heart Association.

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Imaging Detects Cardiac Abnormalities in Endocarditis

TUESDAY, Jan. 27 (HealthDay News) -- Multislice computed tomography (CT) is effective in detecting valvular abnormalities in patients with suspected infective endocarditis compared with transesophageal echocardiography and surgical specimens, researchers report in the Feb. 3 issue of the Journal of the American College of Cardiology.

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Clinical Information Technology Leads to Safer Hospitals

TUESDAY, Jan. 27 (HealthDay News) -- Hospitals that make use of clinical information technology to automate notes, records, order entry and clinical decision support have lower mortality rates, fewer complications and also save money, according to a report published in the Jan. 26 issue of the Archives of Internal Medicine.

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Prolonged Use of Loop Diuretics May Raise Fracture Risk

MONDAY, Jan. 26 (HealthDay News) -- Postmenopausal women who use loop diuretics are at increased risk of fractures, according to a report published in the Jan. 26 issue of the Archives of Internal Medicine.

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AHA Reveals Top 10 Heart Disease Research Advances

MONDAY, Jan. 26 (HealthDay News) -- The American Heart Association (AHA) has released its annual top 10 list of advances in research into heart disease and stroke, with a study on the impact of smoke-free legislation on hospitalizations for acute coronary syndrome topping the list.

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Smoking Causes Over 440,000 US Deaths Each Year

MONDAY, Jan. 26 (HealthDay News) -- There were an estimated 443,000 deaths a year from 2000 to 2004 attributable to smoking and exposure to secondhand smoke in the United States, according to a report published in the Jan. 23 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Impaired Kidney Function Linked to Mortality in Elderly

FRIDAY, Jan. 23 (HealthDay News) -- Impaired kidney function is associated with a higher risk of death and cardiovascular disease in elderly individuals at risk of vascular disease, while statins reduce the risk of death and heart attack in patients with impaired kidney function, according to the results of a study published online Jan. 20 in PLoS Medicine.

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Novel Biomarkers Predict Death, Myocardial Infarction

THURSDAY, Jan. 22 (HealthDay News) -- When patients are admitted to the hospital with ischemic-type chest pain, two novel biomarkers can provide useful prognostic information, according to research published in the Jan. 1 issue of the American Journal of Cardiology.

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Cholesterol Particle Size Associated with Coronary Risk

THURSDAY, Jan. 22 (HealthDay News) -- There is an association between the risk of coronary artery disease and both size and concentration of high-density lipoprotein, although the former is explained by markers associated with the metabolic syndrome, according to research published in the Jan. 20 issue of the Annals of Internal Medicine.

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Warfarin-Related Genotyping Not Cost-Effective

THURSDAY, Jan. 22 (HealthDay News) -- Genetic testing prior to initiation of warfarin therapy is only cost-effective in patients who are at high risk for hemorrhage, and is not cost-effective for typical patients with non-valvular atrial fibrillation, according to a report published in the Jan. 20 issue of the Annals of Internal Medicine.

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Heart Function Linked to Exercise Capacity

TUESDAY, Jan. 20 (HealthDay News) -- Left ventricular resting diastolic function is strongly associated with exercise capacity, along with age, sex and body mass index, according to a report in the Jan. 21 issue of the Journal of the American Medical Association.

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Genetic Variants Predict Heart Disease in Women

TUESDAY, Jan. 20 (HealthDay News) -- Although genetic variations in chromosome 9p21.3 are associated with incident cardiovascular disease in white women, they do not add to the predictive value of traditional risk factors, high-sensitivity C-reactive protein or a family history of premature heart attack, according to a report published in the Jan. 20 issue of the Annals of Internal Medicine.

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Severity of Myocardial Infarction Has Declined

TUESDAY, Jan. 20 (HealthDay News) -- There was a decline in the severity of myocardial infarction from 1987 to 2002, which could help explain the reduction in mortality due to coronary heart disease, according to the results of a study published online Jan. 19 in Circulation: Journal of the American Heart Association.

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Awareness of Peripheral Arterial Disease Lacking

TUESDAY, Jan. 20 (HealthDay News) -- Compared with knowledge of other cardiovascular diseases, the Canadian public is unaware of the risks of peripheral arterial disease, according to study findings published in the January issue of the Canadian Journal of Cardiology.

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Coronary Artery Calcium Helps Predict Cardiac Outcome

TUESDAY, Jan. 20 (HealthDay News) -- The absolute coronary artery calcium score is a better predictor of cardiovascular outcomes than age, sex and race/ethnicity, according to a report published in the Jan. 27 issue of the Journal of the American College of Cardiology.

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Heart Risk Linked to Metabolic Syndrome and Smoking

TUESDAY, Jan. 20 (HealthDay News) -- In China, older adults with metabolic syndrome who are exposed to either active or passing smoking have an increased risk of cardiovascular disease, according to a report published in the Jan. 27 issue of the Journal of the American College of Cardiology.

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Metabolic Syndrome Common Among Football Linemen

MONDAY, Jan. 19 (HealthDay News) -- Collegiate football linemen may be at risk of cardiovascular disease because of metabolic syndrome, according to a study published in the November/December issue of the Journal of Athletic Training.

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Gender Disparity Seen in Emergency Service Time

THURSDAY, Jan. 15 (HealthDay News) -- Women with cardiac symptoms are 50 percent more likely than men to be delayed during emergency medical services (EMS) intervention, according to a report published online Jan. 13 in Circulation: Cardiovascular Quality and Outcomes.

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More Beneficiaries of Statin Therapy Identified

THURSDAY, Jan. 15 (HealthDay News) -- Statin therapy may benefit people without elevated low-density lipoprotein levels but with elevated high-sensitivity C-reactive protein levels, according to study findings published online Jan. 13 in Circulation: Cardiovascular Quality and Outcomes.

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Admission Lipid Levels Often Not Ideal in Heart Disease

THURSDAY, Jan. 15 (HealthDay News) -- Patients hospitalized for coronary artery disease often have non-ideal lipid levels at admission and few are taking lipid-lowering medications before admission, according to a report in the January issue of the American Heart Journal.

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Axxess Stents Effective for Coronary Bifurcation Lesions

THURSDAY, Jan. 15 (HealthDay News) -- The Axxess self-expanding, drug-eluting stent is safe and effective in treating coronary bifurcation lesions, according to the results of a study published online Jan. 14 in the Journal of the American College of Cardiology.

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Ratio of Sodium to Potassium Affects Heart Disease Risk

THURSDAY, Jan. 15 (HealthDay News) -- A high ratio of excreted sodium to potassium is associated with a subsequently higher risk of cardiovascular disease, according to a report published in the Jan. 12 issue of the Archives of Internal Medicine.

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Atypical Antipsychotics Linked to Sudden Cardiac Death

WEDNESDAY, Jan. 14 (HealthDay News) -- Current users of atypical antipsychotic drugs have a comparable dose-dependent increased risk of sudden cardiac death as users of typical antipsychotic drugs, according to study findings published in the Jan. 15 issue of the New England Journal of Medicine.

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Stent Placement Technique Leads to Superior Outcomes

WEDNESDAY, Jan. 14 (HealthDay News) -- In patients with multivessel coronary artery disease who undergo percutaneous coronary intervention with drug-eluting stents, routine measurement of fractional flow reserve in addition to angiography is associated with significantly improved outcomes compared to angiography alone, according to a report published in the Jan. 15 issue of the New England Journal of Medicine.

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Ventricular Devices Increase Post-Transplant Mortality

WEDNESDAY, Jan. 14 (HealthDay News) -- Ventricular assist devices (VADs) used as a bridge to heart transplantation increase post-transplant mortality, researchers report in the Jan. 20 issue of the Journal of the American College of Cardiology.

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Experts Call for Acute Heart Failure Syndrome Research

WEDNESDAY, Jan. 14 (HealthDay News) -- Among patients admitted to the hospital with acute heart failure syndromes, the majority have coronary artery disease, according to a consensus summary published in the Jan. 20 issue of the Journal of the American College of Cardiology.

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Early Atherosclerosis Tied to Lifetime Cardiovascular Risk

WEDNESDAY, Jan. 14 (HealthDay News) -- In individuals with a low 10-year risk of cardiovascular disease, having a high lifetime risk of cardiovascular disease is associated with more signs of subclinical atherosclerosis, according to a report published online Jan. 12 in Circulation: Journal of the American Heart Association.

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Treadmill Use Beneficial in Peripheral Arterial Disease

TUESDAY, Jan. 13 (HealthDay News) -- Treadmill training improved walking endurance in patients with peripheral arterial disease (PAD), both with and without symptoms of intermittent claudication, according to research published in the Jan. 14 issue of the Journal of the American Medical Association.

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Veteran Co-Pay Increase Affected Medication Adherence

TUESDAY, Jan. 13 (HealthDay News) -- After the U.S. Department of Veterans Affairs (VA) increased 30-day prescription co-payments from $2 to $7 in February 2002, veterans' adherence to lipid-lowering medications significantly declined, according to a report released online Jan. 12 in advance of publication in an upcoming issue of Circulation: Journal of the American Heart Association.

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No Consensus on the Pill and Cardiovascular Risks

TUESDAY, Jan. 13 (HealthDay News) -- There is no clear consensus on the possible protective benefits of oral contraceptives against atherosclerosis and cardiovascular events, researchers report in the Jan. 20 issue of the Journal of the American College of Cardiology.

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Outdoor Temperature Affects Blood Pressure in Elderly

TUESDAY, Jan. 13 (HealthDay News) -- There is a strong association between outdoor air temperature and blood pressure in the elderly, and monitoring should be stepped up during times of extreme heat or cold, according to a report published in the Jan. 12 issue of the Archives of Internal Medicine.

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Pulse Oximetry Screening Promising for Heart Defects

FRIDAY, Jan. 9 (HealthDay News) -- Using pulse oximetry to screen babies in maternity units significantly improved detection of duct dependent circulation before the babies were discharged, with evidence suggesting such screenings were cost-effective, according to research published online Jan. 8 in BMJ.

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Risk Factors Falter in Predicting Heart Issues

FRIDAY, Jan. 9 (HealthDay News) -- The use of traditional risk factors in predicting cardiovascular mortality or coronary atherosclerotic disease faces shortcomings, according to two studies published online Jan. 8 in BMJ and in the January issue of the American Journal of Roentgenology.

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Defibrillators May Benefit High-Risk Groups

THURSDAY, Jan. 8 (HealthDay News) -- In older patients and those with a limited number of major comorbid conditions, the survival benefits and cost-effectiveness of implantable cardioverter-defibrillator (ICD) therapy are similar to those observed in younger, healthier patients, according to a report published online Jan. 6 in Circulation: Cardiovascular Quality and Outcomes.

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Coronary Revascularization Use Guidelines Released

THURSDAY, Jan. 8 (HealthDay News) -- Appropriate use guidelines for coronary revascularization -- developed jointly by the American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and American Society of Nuclear Cardiology -- were released online Jan. 5 in the Journal of the American College of Cardiology, as well as in Catheterization and Cardiovascular Interventions and Circulation: Journal of the American Heart Association.

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Arterial Oxygen Pressure Drop at High Elevation Studied

WEDNESDAY, Jan. 7 (HealthDay News) -- In extremely high altitudes, people experience an elevated difference in alveolar-arterial oxygen, suggesting a functional limitation in pulmonary diffusion or a degree of subclinical pulmonary edema, according to research published in the Jan. 8 issue of the New England Journal of Medicine.

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HIF-1 Offers Target for Digoxin in Cancer Therapy

WEDNESDAY, Jan. 7 (HealthDay News) -- Cardiac glycosides -- used in treating congestive heart failure and arrhythmias -- appear to be strong inhibitors of hypoxia-inducible factor 1α (HIF-1α) synthesis, providing evidence that supports the use of drugs like digoxin for cancer treatment, according to research published Dec. 16 in the Proceedings of the National Academy of Sciences.

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Drugs Linked to Survival in Some Heart Failure Patients

TUESDAY, Jan. 6 (HealthDay News) -- Initiating beta-blocker therapy upon hospital discharge was linked to improved survival in older heart failure patients with left ventricular systolic dysfunction, but not those with preserved systolic function, according to research published in the Jan. 13 issue of the Journal of the American College of Cardiology.

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Cardiocerebral Resuscitation May Improve Survival

TUESDAY, Jan. 6 (HealthDay News) -- Cardiocerebral resuscitation (CCR) -- an alternative approach to cardiopulmonary resuscitation (CPR) for patients with cardiac arrest -- emphasizes chest compressions over mouth-to-mouth ventilation for bystanders and new protocols for emergency responders, according to an article in the Jan. 13 issue of the Journal of the American College of Cardiology.

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Depression Linked to Higher Heart Costs in Women

TUESDAY, Jan. 6 (HealthDay News) -- Depression, as defined via several different methods, was associated with higher cardiovascular costs over five years in women with suspected myocardial ischemia, according to research published in the Jan. 13 issue of the Journal of the American College of Cardiology.

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Statins Reduce Delirium Risk After Cardiac Surgery

TUESDAY, Jan. 6 (HealthDay News) -- Statin treatment before cardiac bypass surgery reduces the risk of postoperative delirium, particularly in elderly patients, according to a report in the January issue of Anesthesiology.

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Smoke-Free Law Cuts Heart Attacks Over Three-Year Period

MONDAY, Jan. 5 (HealthDay News) -- Hospitalizations due to heart attacks were markedly reduced in the three years following the enactment of a Pueblo, Colo., city law banning smoking in workplaces and public places, according to a report published in the Jan. 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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