July 2010 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for July 2010. 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.

Black Youths May Benefit From Higher Vitamin D Dose

FRIDAY, July 30 (HealthDay News) -- Black youths on 2000 IU/day of vitamin D achieve higher vitamin D levels more quickly and have significantly less arterial stiffness than those on 400 IU/day, according to research published online July 21 in the Journal of Clinical Endocrinology and Metabolism.

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Calcium Supplements May Increase Heart Attack Risk

FRIDAY, July 30 (HealthDay News) -- Calcium supplementation is associated with an increased risk of myocardial infarction, according to a meta-analysis published online July 29 in BMJ.

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Specialties See Modest Compensation Increases in '09

FRIDAY, July 30 (HealthDay News) -- Most medical specialties saw modest compensation increases in 2009, but many provider organizations are still operating at a substantial loss, according to the findings of the American Medical Group Association's (AMGA) 2010 Medical Group Compensation and Financial Survey.

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Two Studies Offer Support for Compression-Only CPR

WEDNESDAY, July 28 (HealthDay News) -- Instructions from emergency dispatchers to give cardiopulmonary resuscitation (CPR) with chest compressions only or compressions with rescue breathing are associated with similar survival rates, according to two studies published in the July 29 New England Journal of Medicine.

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Hospital Strategy to Increase PCI Use May Be Unneeded

TUESDAY, July 27 (HealthDay News) -- Hospital-based strategies for increasing patient access to primary percutaneous coronary intervention (PCI) for treatment of ST-segment elevation myocardial infarction (STEMI) may not be the best option in terms of cost and effectiveness if emergency medical services (EMS) are sufficient for getting patients to the care they need, according to research published online July 27 in Circulation: Cardiovascular Quality and Outcomes.

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HIV Care Quality in VA Hospitals Generally High

TUESDAY, July 27 (HealthDay News) -- National performance rates for quality-of-care measures for HIV patients receiving care through the Department of Veterans Affairs (VA) are generally high, though there is variation from facility to facility, according to a study in the July 26 Archives of Internal Medicine. Another study in the same issue suggests that some HIV drugs increase the risk of heart attack in HIV-infected patients.

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Women's BP Measurements Higher When Taken by Doctors

TUESDAY, July 27 (HealthDay News) -- Female patients with normal blood pressure (BP) may have significantly higher systolic and diastolic readings when their BP is taken by a physician rather than a nurse or automated device, according to research published in the August issue of Applied Nursing Research.

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Alteplase Remains Safe Up to 4.5 Hours After Acute Stroke

TUESDAY, July 27 (HealthDay News) -- Extending the treatment window for administration of alteplase from three hours to 4.5 hours in patients who experience an acute ischemic stroke is safe and does not result in delayed treatment of patients, according to a study published online July 27 in The Lancet Neurology.

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Coronary Artery Bypass Graft Volume Affects Costs

TUESDAY, July 27 (HealthDay News) -- Hospitals, and to a lesser extent surgeons, who have a low volume of coronary artery bypass graft (CABG) surgeries tend to incur higher costs, according to research published in the July 26 issue of the Archives of Internal Medicine.

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Cardiac Function Poor in Many Childhood Cancer Survivors

MONDAY, July 26 (HealthDay News) -- Decreased cardiac function occurs in 27 percent of five-year childhood cancer survivors (CCSs), and higher cumulative anthracycline dose, radiation to the thorax, and younger age at diagnosis are all associated with left ventricular shortening fraction (LVSF) in these patients, according to a study in the July 26 issue of the Archives of Internal Medicine.

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Odds of Medicare Carotid Procedures Differ Regionally

MONDAY, July 26 (HealthDay News) -- There are significant regional variations in the odds of Medicare beneficiaries undergoing a carotid revascularization procedure, according to research published in the July 26 issue of the Archives of Internal Medicine.

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Direct Trip to Intervention Center Improves STEMI Outcomes

FRIDAY, July 23 (HealthDay News) -- Pre-hospital triage of ST-segment elevation myocardial infarction (STEMI) with direct transport to an intervention center is associated with decreased symptom-to-balloon time and a lower mortality rate, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Heart Failure Emergency Care, Physician Skill Sets Explored

FRIDAY, July 23 (HealthDay News) -- The competencies required for physicians caring for heart failure and transplant patients and the need for research to better manage heart failure in emergency departments are explored in a pair of reports published in the July 27 issue of the Journal of the American College of Cardiology.

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Nurse-Run Program Reduces Cardiac Risk Factors After MI

FRIDAY, July 23 (HealthDay News) -- A nurse-managed secondary prevention program may improve cardiovascular risk factors among individuals who have suffered a myocardial infarction, according to a study published in the August issue of Applied Nursing Research.

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Generic Lovenox Approved for Deep Vein Thrombosis

FRIDAY, July 23 (HealthDay News) -- The first generic version of enoxaparin sodium injection (brand name: Lovenox), a blood-thinning drug designed to prevent deep vein thrombosis (DVT), has been approved by the U.S. Food and Drug Administration.

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Nebivolol Less Effective in Elderly With CHF and Diabetes

FRIDAY, July 23 (HealthDay News) -- In patients aged 70 and older with heart failure, diabetes is associated with a worse prognosis, and nebivolol is less effective in patients with diabetes than in those without it, according to research published in the July 1 issue of the American Journal of Cardiology.

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Heart Failure Mortality Down Significantly in Veterans

FRIDAY, July 23 (HealthDay News) -- Although veterans with heart failure have presented with more comorbidities and have been rehospitalized more frequently in recent years, their 30-day mortality rates have decreased significantly, according to a study in the July 27 issue of the Journal of the American College of Cardiology.

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Folate-Related Genes Plus Lifestyle Tied to Heart Defects

THURSDAY, July 22 (HealthDay News) -- Women who have functional single-nucleotide polymorphisms in folate-related genes as well as lifestyle factors that may alter folate metabolism appear to be at increased risk of having a fetus with a congenital heart defect (CHD), according to a study published in the August issue of Obstetrics & Gynecology.

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Patient-Centered Care Linked to Improved AMI Survival

THURSDAY, July 22 (HealthDay News) -- Patient-centered care (PCC) of patients hospitalized for an initial acute myocardial infarction (AMI) is associated with modestly improved survival over a one-year period, according to a study published online July 20 in Health Services Research.

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Phone Intervention Helps Heart Failure Patients Long Term

THURSDAY, July 22 (HealthDay News) -- A telephone intervention aimed at improving education and compliance in heart failure patients can lead to fewer heart failure hospitalizations and a lower death rate than no intervention up to three years after the program ends, according to a study in the July 27 issue of the Journal of the American College of Cardiology.

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Pluripotent Stem Cells Model Cardiac Disease Mechanisms

THURSDAY, July 22 (HealthDay News) -- Researchers have successfully generated pluripotent stem cells capable of recapitulating certain aspects of long-QT syndrome type 1, according to an article published online July 21 in the New England Journal of Medicine.

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When LDL After Statin is Very Low, HDL Not a Risk Factor

THURSDAY, July 22 (HealthDay News) -- Low high-density lipoprotein (HDL) levels are associated with increased cardiovascular risk in patients untreated by statins, but in treated patients who achieve very low low-density lipoprotein (LDL) levels, HDL level is no longer associated with level of risk, according to research published online July 22 in The Lancet.

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Traffic-Related Pollution Tied to Lower Heart Rate Variability

THURSDAY, July 22 (HealthDay News) -- Exposure to traffic-related air pollution is associated with reduced heart rate variability (HRV) in patients with pre-existing heart or lung disease, according to a study published in the July issue of the Journal of Occupational and Environmental Medicine.

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PCB Exposure May Raise Risk for Hypertension

WEDNESDAY, July 21 (HealthDay News) -- Exposure to polychlorinated biphenyls (PCBs) appears to be associated with rates of hypertension, and may have an effect on blood pressure control, according to research published online July 16 in the Journal of Hypertension.

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CHD Risk Factors Common in Young Men and Women

TUESDAY, July 20 (HealthDay News) -- Risk factors for coronary heart disease (CHD) are common among young adults, but they don't seem to alter rates of screening for high cholesterol, according to research published in the July/August issue of the Annals of Family Medicine.

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Depression Linked to Erectile Dysfunction May Raise CV Risk

MONDAY, July 19 (HealthDay News) -- Depressive symptoms in men with erectile dysfunction (ED) constitute an independent risk factor for the incidence of a major cardiovascular event (MACE), according to a study published online July 13 in the Journal of Sexual Medicine.

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Serial CT Angiography Detects Plaque Morphology Changes

FRIDAY, July 16 (HealthDay News) -- Evaluation of coronary plaques with serial computed tomography angiography (CTA) allows interval changes in plaque morphology to be assessed, and statin treatment is linked to decreases in markers associated with plaque instability, according to a study in the July issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

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Myocardial Perfusion Imaging, eGFR Aid in Risk Stratification

FRIDAY, July 16 (HealthDay News) -- In patients with and without diabetes, myocardial perfusion imaging (MPI) and estimated glomerular filtration rate (eGFR) are valuable for risk stratification, and underlying chronic kidney disease (CKD) in diabetes patients is linked to an increased risk of cardiac death, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

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'Ghosts' After Heart Device Removal Linked to Infection

FRIDAY, July 16 (HealthDay News) -- The presence of "ghosts" -- or intracardiac masses noted on echocardiography after device removal -- suggests device infection and may be associated with cardiac device-related infective endocarditis (CDRIE); these ghosts are present in 8 percent of patients after percutaneous device removal, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

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18 Months' Treatment Optimal for Q Fever Endocarditis

FRIDAY, July 16 (HealthDay News) -- Q fever endocarditis should be treated with a combination of doxycycline and hydroxychloroquine for a period of 18 months in patients with native values, and through 24 months in patients with prosthetic valves, according to a retrospective study published online July 15 in The Lancet: Infectious Diseases.

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Stroke Risk Doubled One Hour After Drinking Alcohol

THURSDAY, July 15 (HealthDay News) -- The risk of stroke is more than doubled in the hour after ingestion of alcohol, according to the results of a study published online July 15 in Stroke.

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Algorithm for Quantification of Stenosis Severity Feasible

THURSDAY, July 15 (HealthDay News) -- Quantitative coronary computed tomography angiography (QCCTA) has good correlations with quantitative coronary angiography (QCA) for quantification of stenosis severity in patients with known or suspected coronary artery disease, with QCCTA showing better positive predictive value than visual analysis, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

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BMIPP Data Improve Acute Coronary Syndrome Diagnosis

THURSDAY, July 15 (HealthDay News) -- Use of β-methyl-p-[123I]-iodophenyl-pentadecanoic acid (BMIPP) data in addition to initially available information can help with the early diagnosis of acute coronary syndromes (ACS), according to research published in the July 20 issue of the Journal of the American College of Cardiology.

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Blister Packs of Coumadin Recalled

THURSDAY, July 15 (HealthDay News) -- Bristol-Myers Squibb has initiated a voluntary recall of physician sample blister packs and hospital unit dose (HUD) blister packs of Coumadin, a medication used to treat or prevent blood clots.

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FDA Panel Recommends Avandia Remain on Market

THURSDAY, July 15 (HealthDay News) -- After two days of deliberations, sparked by concerns over cardiovascular safety issues, a U.S. Food and Drug Administration advisory panel, comprising 33 experts, has recommended that rosiglitazone (Avandia) remain on the market with tightened controls or restricted sales.

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Excess Mortality Persists in Childhood Cancer Survivors

TUESDAY, July 13 (HealthDay News) -- Long-term childhood cancer survivors face an increased mortality risk even 45 years after diagnosis, with the bulk of the excess mortality being from second primary cancers and circulatory diseases, according to research published in the July 14 issue of the Journal of the American Medical Association.

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Exercise May Worsen Mitral Regurgitation

TUESDAY, July 13 (HealthDay News) -- Degenerative mitral regurgitation (MR) may worsen with increases in systolic pulmonary artery pressure (PAP) caused by exercise, which could lower chances for symptom-free survival, according to research published in the July 20 issue of the Journal of the American College of Cardiology.

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Hospital Care of Heart Attack Patients Has Improved

TUESDAY, July 13 (HealthDay News) -- Hospitals nationwide have improved their care of heart attack patients and are increasingly administering therapies -- such as percutaneous coronary intervention (PCI) -- in a timely manner, safely, and according to clinical guidelines, according to a new analysis of data from the American College of Cardiology's National Cardiovascular Data Registry published in the July 20 issue of the Journal of the American College of Cardiology.

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AHA Offers Recommendations for Diet and Exercise Programs

MONDAY, July 12 (HealthDay News) -- Behavioral modification programs combining careful goal-setting, frequent provider counseling, and self-monitoring of diet and exercise are the most effective way to help individuals successfully make healthy lifestyle changes to reduce their risk for cardiovascular diseases, according to an American Heart Association (AHA) scientific statement published online July 12 in Circulation.

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Diffusion-Weighted Imaging Superior for Stroke Diagnosis

MONDAY, July 12 (HealthDay News) -- Diffusion-weighted imaging (DWI) is accurate and appears to be more useful than noncontrast computed tomography (CT) for diagnosing acute ischemic stroke within 12 hours after symptoms appear; however, there is not enough evidence to support or refute the efficacy of perfusion-weighted imaging (PWI) in diagnosing acute ischemic stroke, according to an analysis published in the July 13 issue of Neurology.

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Obstructive Sleep Apnea Tied to Heart Failure Risk in Men

MONDAY, July 12 (HealthDay News) -- Obstructive sleep apnea (OSA) is associated with an increased risk of incident heart failure in middle-aged and older men but not in women of any age, and it may also be associated with incident coronary heart disease in men 70 years of age and younger, according to a study published online July 12 in Circulation.

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Family History-Based Lipid Screening Misses Some Children

MONDAY, July 12 (HealthDay News) -- Use of family history to determine which children need cholesterol screening -- instead of using universal cholesterol screening -- is likely to miss some children who have dyslipidemia, and fail to detect many who may have genetic dyslipidemias requiring pharmacologic treatment, according to a study published online July 12 in Pediatrics.

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Infant Heart Defects Linked to Pregnancy Bupropion Use

MONDAY, July 12 (HealthDay News) -- Maternal use of bupropion during early pregnancy appears to have a modest positive association with left outflow tract heart defects in infants, according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.

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Wearable Defibrillator Shows Benefits in Mortality

FRIDAY, July 9 (HealthDay News) -- Nationwide, wearable cardioverter-defibrillator (WCD) compliance is satisfactory, and use of the device is associated with low sudden death mortality, though asystole is an important cause of mortality, according to research published in the July 13 issue of the Journal of the American College of Cardiology.

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Personalized Video May Be Useful Anti-Smoking Tool

FRIDAY, July 9 (HealthDay News) -- A personalized video that simulates the impact of a myocardial infarction for smokers could be useful as a smoking cessation tool, according to research published in the July 1 issue of the American Journal of Cardiology.

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Heart Rate Measures May Predict Kidney Disease Risk

FRIDAY, July 9 (HealthDay News) -- High resting heart rate and low heart rate variability appear to be associated with increased risk of end-stage renal disease (ESRD) and hospitalization related to chronic kidney disease (CKD), according to a study published online July 8 in the Journal of the American Society of Nephrology.

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Sudden Cardiac Death May Affect Women's Mortality Less

FRIDAY, July 9 (HealthDay News) -- Women with dilated cardiomyopathy enrolled in primary prevention implantable cardioverter-defibrillator (ICD) trials have the same overall mortality as men but undergo significantly fewer appropriate ICD interventions, implying a smaller impact of sudden cardiac death on overall mortality in women, according to a systematic review and meta-analysis published in the July issue of Heart Rhythm.

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Qigong and Tai Chi Have Multiple Health Benefits

THURSDAY, July 8 (HealthDay News) -- The combined outcomes of 77 studies on Qigong and Tai Chi suggest that these practices have a positive effect on multiple areas of health and well-being, according to a review published in the July/August issue of the American Journal of Health Promotion.

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Cardiac Imaging Confers Substantial Radiation Exposure

THURSDAY, July 8 (HealthDay News) -- For many patients, cardiac imaging that uses ionizing radiation results in substantial radiation exposure, with annual effective doses increasing with age, according to research published online July 7 in the Journal of the American College of Cardiology.

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Telemonitoring, Self-Titration Tied to Lower Blood Pressure

THURSDAY, July 8 (HealthDay News) -- Patients who self-manage their antihypertensive medication and engage in telemonitoring of their blood pressure (BP) measurements appear to fare better than patients who receive conventional treatment for hypertension, according to a study published online July 8 in The Lancet.

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Radiation Training May Be Lacking in Cardiology Fellows

THURSDAY, July 8 (HealthDay News) -- Cardiology fellows appear to be inadequately educated about radiation safety, according to research published in the July 1 issue of the American Journal of Cardiology.

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Many Doctors in Specialties Other Than Their Early Choices

WEDNESDAY, July 7 (HealthDay News) -- Ten years after graduation, approximately one-fourth of doctors work in a specialty other than the one they chose in their third year post-graduation, according to research published online July 6 in BMJ.

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SPECT Imaging Helps Judge Sudden Cardiac Death Risk

WEDNESDAY, July 7 (HealthDay News) -- For patients with coronary artery disease (CAD) and left ventricular ejection fraction (LVEF) greater than 35 percent, single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) can help identify those at higher risk for sudden cardiac death (SCD), according to a study in the July 13 issue of the Journal of the American College of Cardiology.

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Flavanols Improve CV Function in Coronary Disease Patients

WEDNESDAY, July 7 (HealthDay News) -- In coronary artery disease (CAD) patients, regular dietary intake of flavanols is associated with improvements in endothelial dysfunction and mobilization of functional circulating angiogenic cells (CACs), according to a study in the July 13 issue of the Journal of the American College of Cardiology.

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E-mail Use Associated With Improved Care Effectiveness

WEDNESDAY, July 7 (HealthDay News) -- The incorporation of secure patient-provider e-mails has been identified by the American Recovery and Reinvestment act as an objective for electronic health records, and it does appear to improve the effectiveness of care in patients with diabetes, hypertension, or both, according to research published in the July issue of Health Affairs.

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Weekend ICU Admission Linked to Higher Mortality Risk

WEDNESDAY, July 7 (HealthDay News) -- Patients admitted to hospital intensive care units (ICUs) on the weekends may have an increased mortality risk, but those admitted at night do not appear to have a higher mortality risk, according to research published in the July issue of Chest.

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Nutraceutical Drug Use Often Ignored by Clinicians

WEDNESDAY, July 7 (HealthDay News) -- Although the use of nutraceuticals and nonprescription over-the-counter (OTC) drugs may be high among patients, cardiovascular clinicians may largely ignore the use of these agents among their patients, according to research published in the July 6 issue of the Annals of Internal Medicine.

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Generalized Anxiety Linked to Poor Cardiac Outcomes in CHD

WEDNESDAY, July 7 (HealthDay News) -- Generalized anxiety disorder (GAD) is associated with an increased risk of cardiovascular events in patients with stable coronary heart disease (CHD), and disease severity does not explain this association, according to a study in the July issue of the Archives of General Psychiatry.

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Tight BP Control May Not Benefit Patients With Diabetes, CAD

TUESDAY, July 6 (HealthDay News) -- Individuals with diabetes and coronary artery disease (CAD) do not appear to have improved cardiovascular outcomes when they achieve tight control of systolic blood pressure as opposed to usual control, according to research published in the July 7 issue of the Journal of the American Medical Association.

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Cardiac, Pulmonary Function of Ticagrelor Patients Studied

TUESDAY, July 6 (HealthDay News) -- Dyspnea is commonly reported by coronary artery disease (CAD) patients taking ticagrelor, but it does not appear to have a negative impact on cardiac or pulmonary function in these patients, according to research published in the July 13 issue of the Journal of the American College of Cardiology.

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Out-of-Hospital CHD Mortality Higher in Young Men

FRIDAY, July 2 (HealthDay News) -- Young men have a higher rate of out-of-hospital coronary heart disease (CHD) mortality than young women, which could partly explain the fact that young women are more likely than young men to die when hospitalized for myocardial infarction (MI), according to research published in the July 1 issue of the American Journal of Cardiology.

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TMP-SMX Associated With Hyperkalemia in Elderly

FRIDAY, July 2 (HealthDay News) -- Older patients taking trimethoprim-sulfamethoxazole (TMP-SMX) have a substantially increased risk of hyperkalemia requiring hospitalization, but being on β-blockers does not further increase this risk, according to research published online July 1 in the Clinical Journal of the American Society of Nephrology.

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Higher Fructose Intake Tied to Increased Hypertension Risk

FRIDAY, July 2 (HealthDay News) -- Despite inconsistent findings from previous studies, high intakes of fructose are associated with an increased risk of developing hypertension, according to research published online July 1 in the Journal of the American Society of Nephrology.

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Early Stroke Complications Rob Patients of Healthy Years

THURSDAY, July 1 (HealthDay News) -- Early complications following ischemic stroke cost patients about two years' worth of optimal health, in addition to the loss of optimal health due to the stroke itself, and a higher number of complications is linked to a larger loss of healthy life-years, according to research published online July 1 in Stroke.

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Report Addresses Physician Financial Conflicts in Care

THURSDAY, July 1 (HealthDay News) -- In a new report, the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that ensure financial relationships between physicians and industry do not result in conflicts of interest that influence patient care.

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Continuous Flow Device Associated With Bleeding

THURSDAY, July 1 (HealthDay News) -- Patients who receive a commonly used axial flow pump, the HeartMate II (HM II), are at high risk for major bleeding during both long-term support and heart transplantation, possibly due to acquired von Willebrand syndrome, according to research published online June 30 in the Journal of the American College of Cardiology.

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Sprint Fidelis Lead Extraction Safe at High-Volume Centers

THURSDAY, July 1 (HealthDay News) -- Extraction of Sprint Fidelis defibrillator leads can be performed safely in high-volume settings, though longer implantation duration is associated with greater need for countertraction sheath (CTS) assistance, according to research published online June 30 in the Journal of the American College of Cardiology.

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