Here are what the editors at HealthDay consider to be the most important developments in Cardiology for July 2011. 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.
Intensive Glycemic Control Does Not Improve Renal Outcome
FRIDAY, July 29 (HealthDay News) -- In older patients with type 2 diabetes, intensive glycemic control does not improve renal disease progression, but it is associated with reduction in nephropathy progression in patients with worse microvascular eye disease, higher body mass index (BMI), and lower diastolic blood pressure (DBP), according to a study published online July 20 in Diabetes Care.
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Low-Molecular-Weight Heparin Better for Primary PCI
FRIDAY, July 29 (HealthDay News) -- Compared to unfractionated heparin (UFH), low-molecular-weight heparin (LMWH) is associated with reduced mortality and reduced major bleeding in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI); but it shows no benefit in those treated with PCI after thrombolysis, according to a study published online July 20 in the Journal of Thrombosis and Haemostasis.
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Baroreflex Activation Therapy Tied to Safe SBP Reduction
FRIDAY, July 29 (HealthDay News) -- Baroreflex activation therapy (BAT) can safely reduce systolic blood pressure (SBP) over the long term in patients with resistant hypertension, according to a study published online July 28 in the Journal of the American College of Cardiology.
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Pregnancy-Related Stroke Hospitalizations Rise in the U.S.
THURSDAY, July 28 (HealthDay News) -- The rate of pregnancy-related hospitalizations for stroke have increased in the United States, especially during the postpartum period, from 1994-1995 to 2006-2007, mainly due to changes in prevalence of hypertension and heart disease, according to a study published online July 28 in Stroke.
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Coronary Events Are More Heritable Than Cerebral Events
THURSDAY, July 28 (HealthDay News) -- Coronary events are more heritable than cerebral events, with myocardial infarction (MI) significantly more likely than stroke to cluster in families, according to a study published online July 26 in Circulation: Cardiovascular Genetics.
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CDH13 Linked to Lowered Levels of Adiponectin
WEDNESDAY, July 27 (HealthDay News) -- A single nucleotide polymorphism (SNP) in the T-cadherin (CDH13) gene is associated with lowered adiponectin levels and an increased risk of cardiometabolic diseases, according to a study published online July 19 in Diabetes.
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Model Using HbA1c Level Improves CVD Risk Prediction
WEDNESDAY, July 27 (HealthDay News) -- Models that incorporate hemoglobin A1c (HbA1c) levels for patients with diabetes have improved predictive ability of cardiovascular disease (CVD) risk compared to classification of diabetes as a cardiovascular risk equivalent, according to a study published online July 25 in the Archives of Internal Medicine.
Vascular Changes Contribute to Dementia in Older People
WEDNESDAY, July 27 (HealthDay News) -- Vascular changes contribute to age-related vascular cognitive impairment (VCI) and dementia, according to a new American Heart Association/American Stroke Association scientific statement published online July 21 in Stroke.
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Intensive Glucose Lowering Offers No Benefit on Mortality
WEDNESDAY, July 27 (HealthDay News) -- Intensive glucose-lowering treatment shows no significant reduction in all-cause mortality or deaths from cardiovascular causes in adults with type 2 diabetes, according to a meta-analysis published online July 26 in BMJ.
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Apixaban Ups Bleeding Without Reducing Ischemic Events
TUESDAY, July 26 (HealthDay News) -- Adding 5 mg of apixaban twice daily to antiplatelet therapy among high-risk patients after an acute coronary syndrome increases the risk of bleeding events without a significant reduction in recurrent ischemic events, according to a study published online July 24 in the New England Journal of Medicine.
New Biomarkers of Coronary Heart Disease Identified
TUESDAY, July 26 (HealthDay News) -- In patients with type 2 diabetes, higher circulating levels of soluble receptor for advanced glycation endproducts (sRAGE), and its secreted isoform (esRAGE) are strongly associated with coronary heart disease (CHD), but not stroke, according to a study published online July 19 in Diabetes.
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Optimism Linked to Reduced Risk of Stroke in Older Adults
TUESDAY, July 26 (HealthDay News) -- Increased optimism is associated with a decreased risk of stroke in older adults, even after adjusting for sociodemographic, behavioral, biological, and psychological stroke risk factors, according to a study published online July 21 in Stroke.
Dual Metabolic Defects Tied to Hypertriglyceridemia in Obese
MONDAY, July 25 (HealthDay News) -- Hypertriglyceridemia in obese men can be attributed to dual metabolic defects of increased secretion and impaired clearance of triglyceride-rich very-low-density lipoprotein1 (VLDL1), according to a study published online July 21 in Arteriosclerosis, Thrombosis, and Vascular Biology.
FDA: Chantix Tied to Slight Risk of Cardiac Events
MONDAY, July 25 (HealthDay News) -- The U.S. Food and Drug Administration notified health care professionals and patients that the drug label for varenicline (Chantix) was updated to include information about the effectiveness and safety of the drug when used in patients with chronic obstructive pulmonary disease (COPD) or cardiovascular disease.
Unexplained Higher Hemorrhage Risk in PAD, CVD Patients
MONDAY, July 25 (HealthDay News) -- Patients with peripheral arterial obstructive disease (PAD) or cerebrovascular disease (CVD) have a higher risk of hemorrhagic events than those with coronary artery disease (CAD), though this difference cannot be explained by known risk factors, use of antithrombotics, or genetic variations in hemostasis, according to a study published online July 13 in the Journal of Thrombosis and Haemostasis.
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Meta-Analysis Shows 8 SNPs Tied to Metabolic Syndrome
MONDAY, July 25 (HealthDay News) -- Eight single nucleotide polymorphisms (SNPs) are associated with metabolic syndrome (MetS), mostly located in genes involved in dyslipidemia, according to a meta-analysis published online July 12 in Obesity Reviews.
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FDA: Dronedarone Tied to Cardiovascular Events, Death
FRIDAY, July 22 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals and patients that dronedarone (Multaq) may be associated with an increased risk of death and adverse cardiovascular events, including stroke and hospitalization for heart failure.
Prenatal Nicotine Exposure Tied to Vascular Dysfunction
FRIDAY, July 22 (HealthDay News) -- Prenatal nicotine exposure in rats can increase the production of reactive oxygen species (ROS) resulting in vascular hypertensive reactivity in male offspring, according to an experimental study published online July 21 in the British Journal of Pharmacology.
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Being Married Linked to Earlier Care After Chest Pain
FRIDAY, July 22 (HealthDay News) -- Though married status is associated with lower odds of delayed medical care after chest pain, married men are significantly more likely to present earlier for care after myocardial infarction (MI) with chest pain, but married women show no such benefit, according to a study published online July 18 in CMAJ, the journal of the Canadian Medical Association.
Brilinta Approved for Acute Coronary Syndromes
THURSDAY, July 21 (HealthDay News) -- Brilinta (ticagrelor) has been approved by the U.S. Food and Drug Administration to help reduce the risk of heart attack and cardiovascular death among people with acute coronary syndromes (ACS).
Medical Students Support Right to Conscientious Objection
THURSDAY, July 21 (HealthDay News) -- Nearly half of medical students in the United Kingdom, especially Muslims, believe in the right of doctors to conscientiously object to or refuse any procedure, according to a study published online July 18 in the Journal of Medical Ethics.
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Intima-Media Thickness Predicts Cardiovascular Events
WEDNESDAY, July 20 (HealthDay News) -- The maximum intima-media thickness of the internal carotid artery contributes significantly, but modestly, toward improvement in cardiovascular event risk classification based on the Framingham risk score, according to a study published in the July 21 issue of the New England Journal of Medicine.
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Milk, Soy Protein Intake Tied to Reduced Systolic BP
WEDNESDAY, July 20 (HealthDay News) -- Soy and milk protein intake is associated with reduced systolic blood pressure (BP) in patients with prehypertension and stage 1 hypertension, according to a study published online July 18 in Circulation.
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Stopping Low Dose Aspirin Ups Cardiac Risk
WEDNESDAY, July 20 (HealthDay News) -- Discontinuation of low dose aspirin among patients with a history of cardiovascular disease appears to increase the risk for heart attack, according to a study published online July 19 in BMJ.
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Cardio MRI Useful in Diagnosis of Stress Cardiomyopathy
TUESDAY, July 19 (HealthDay News) -- Cardiovascular magnetic resonance (CMR) imaging data can accurately diagnose stress cardiomyopathy (SC) based on specific criteria, according to a study published in the July 20 issue of the Journal of the American Medical Association.
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Statin Therapy Does Not Up Cancer Risk in Older Adults
MONDAY, July 18 (HealthDay News) -- Statin therapy is not associated with a significant increase in cancer risk in older U.S. adults, according to a study published in the July 26 issue of the Journal of the American College of Cardiology.
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A-Fib Ups Risk of Upper-Limb Thromboembolectomy
MONDAY, July 18 (HealthDay News) -- Atrial fibrillation (AF) is associated with an increased risk of upper-limb thromboembolectomy, according to a study published online July 7 in the Journal of Thrombosis and Haemostasis.
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Safety Concern for Chronic NSAID Users With HTN, CAD
MONDAY, July 18 (HealthDay News) -- Chronic, self-reported use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of adverse events in patients with hypertension and coronary artery disease, according to a study published in the July issue of The American Journal of Medicine.
Evidence Supports Modifying Dietary Fat to Lower CV Risk
MONDAY, July 18 (HealthDay News) -- Modification of dietary fat intake, but not the reduction of total fat, is associated with a decreased risk of cardiovascular events, according to a meta-analysis published in the July issue of the Cochrane Database of Systematic Reviews.
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FDA: Nuclear Scan Tied to Higher Radiation Exposure
MONDAY, July 18 (HealthDay News) -- The U.S. Food and Drug Administration warned health care providers and patients of an increased risk of radiation exposure associated with Bracco Diagnostics Inc.'s cardiac positron emission tomography (PET) scans with rubidium (Rb)-82 chloride injection from CardioGen-82.
Post-Surgery VTE Prophylaxis Use Varies Among Hospitals
FRIDAY, July 15 (HealthDay News) -- The use of venous thromboembolism (VTE) prophylaxis after spinal fusion surgery varies widely in U.S. hospitals, according to a study published in the July issue of the Journal of Thrombosis and Haemostasis.
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Clopidogrel, PPIs Linked to MI Risk After PCI
FRIDAY, July 15 (HealthDay News) -- In high-risk cardiovascular patients undergoing percutaneous coronary intervention (PCI), concomitant use of clopidogrel and proton pump inhibitors (PPIs) is associated with an increased risk of cardiac events, specifically myocardial infarction (MI), according to a study published online July 5 in the Journal of Internal Medicine.
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Vascular Disease Tied to Higher Stroke or Death Risk in A-Fib
THURSDAY, July 14 (HealthDay News) -- The presence of a vascular disease, either peripheral artery disease (PAD) or prior myocardial infarction (MI), or both, is associated with increased risk of stroke or death in patients with atrial fibrillation (AF), independent of Cardiac failure, Hypertension, Age, Diabetes, Stroke (doubled) (CHADS2) risk score, according to a study published in the July issue of the Journal of Thrombosis and Haemostasis.
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Pediatric Cardiologists' ECG Analyses Not Always Accurate
THURSDAY, July 14 (HealthDay News) -- Electrocardiograms (ECG) administered to young athletes to determine the suitability of sports participation are difficult for pediatric cardiologists to interpret with complete accuracy, according to a study published online July 14 in The Journal of Pediatrics.
Men With Full-Time Jobs More Active Than Nonworkers
THURSDAY, July 14 (HealthDay News) -- Men with full-time employment, even in sedentary occupations, are significantly more active than healthy non-workers, according to a study published online July 12 in the American Journal of Preventive Medicine.
Intergenerational Social Mobility Affects HTN Risk
THURSDAY, July 14 (HealthDay News) -- Low parental socioeconomic status (SES) is associated with an increased hypertension risk, but intergenerational social mobility modifies this risk, according to a study published online July 11 in the Journal of Epidemiology & Community Health.
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Unhealthy Lifestyle Factors Linked to Sexual Problems
THURSDAY, July 14 (HealthDay News) -- Unhealthy lifestyle factors are associated with sexual inactivity with a partner in sexually active men and women, with sexual dysfunction significantly more likely in men, according to a study published online May 13 in The Journal of Sexual Medicine.
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Fast Food Close to Home Affects Diet in Low-Income Men
WEDNESDAY, July 13 (HealthDay News) -- Availability of supermarket and grocery stores close to home is generally unrelated to diet, but low-income respondents may be sensitive to fast food availability, particularly for men with fast food chains located within 1.00 to 2.99 km of home, according to a study published in the July 11 issue of the Archives of Internal Medicine.
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Histopathologic Complications Seen Post-Intra-Arterial Chemo
WEDNESDAY, July 13 (HealthDay News) -- Though retinoblastoma can be controlled by intra-arterial chemotherapy (IAC), histopathology demonstrates that ocular complications, including thromboembolic events, can occur, according to a study published online July 11 in the Archives of Ophthalmology.
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Occluded Artery Trial Results Have Minimal Impact
WEDNESDAY, July 13 (HealthDay News) -- The results of the Occluded Artery Trial (OAT) and subsequent guideline revisions have not, to date, been fully incorporated into clinical practice in many hospitals in the United States, according to a study published online July 11 in the Archives of Internal Medicine.
Metabolic Syndrome Linked to Cavernosal Vasculopathy
WEDNESDAY, July 13 (HealthDay News) -- Patients with erectile dysfunction (ED) who have metabolic syndrome have higher prevalence of cavernosal vasculopathy than those without metabolic syndrome, and the number of metabolic syndrome components is correlated with cavernosal vasculopathy, according to a study published online July 5 in Diabetes Care.
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Stress ECHO Effectively Stratifies CAD Risk in Patients With HIV
WEDNESDAY, July 13 (HealthDay News) -- Stress echocardiography (SE) can effectively stratify risk and offer prognostic value for patients with HIV at risk for cardiovascular events, according to a study published online July 12 in Circulation: Cardiovascular Imaging.
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High-Volume Exercise Feasible After Bariatric Surgery
TUESDAY, July 12 (HealthDay News) -- Following a high-volume exercise program (HVEP) is feasible for more than 50 percent of patients who have undergone Roux-en-Y gastric bypass and gastric banding, according to a study published in the June 16 issue of Obesity.
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Therapeutic Hypothermia Care Improves STEMI Outcomes
TUESDAY, July 12 (HealthDay News) -- A comprehensive therapeutic hypothermia (TH) protocol integrated into regional ST-segment elevation myocardial infarction (STEMI) treatment improves survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA), according to a study published in the July 12 issue of Circulation.
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Positive Airway Pressure Betters Endothelial Dysfunction
TUESDAY, July 12 (HealthDay News) -- Continuous positive airway pressure (CPAP) mostly reverses endothelial dysfunction and impaired myocardial perfusion in healthy individuals with obstructive sleep apnea (OSA), according to a study published online July 11 in Hypertension.
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Similar Thyroid Risk for Brand-Name, Generic Amiodarone
TUESDAY, July 12 (HealthDay News) -- The incidence of thyroid dysfunction is similar in patients with atrial fibrillation treated with brand-name or generic formulations of amiodarone, according to a study published online July 11 in CMAJ, the journal of the Canadian Medical Association.
Higher Sodium-Potassium Ratio Linked to Mortality Risk
MONDAY, July 11 (HealthDay News) -- A higher sodium-potassium ratio is associated with increased risk for all-cause, cardiovascular disease (CVD), and ischemic heart disease (IHD) mortality in the United States, according to a study published online July 11 in the Archives of Internal Medicine.
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Cardiac Transplants Tied to Increased Risk of Skin Cancer
MONDAY, July 11 (HealthDay News) -- Patients who have undergone cardiac transplants have an increased risk of developing skin cancer, in particular cutaneous squamous cell carcinoma (SCC), compared to the general population, according to a study published in the July issue of the American Journal of Transplantation.
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Satisfaction With Life Linked to Reduced Heart Disease
MONDAY, July 11 (HealthDay News) -- Satisfaction across specific life domains, particularly one's job, family, sex life, and self, is associated with a reduced risk of coronary heart disease (CHD), with the association primarily mediated by angina, according to a study published online July 4 in the European Heart Journal.
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Lower Salt Does Not Reduce Mortality, CV Morbidity
MONDAY, July 11 (HealthDay News) -- Reduced dietary salt intake has no clear effect on mortality or cardiovascular morbidity in populations with normal or high blood pressure, but it is suggested to increase the risk of all-cause death in those with congestive heart failure, according to a review published in the July issue of the Cochrane Database of Systematic Reviews.
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Socioeconomic Status Affects Systolic Blood Pressure
FRIDAY, July 8 (HealthDay News) -- Low socioeconomic status (SES) is associated with increased systolic blood pressure (SBP), and the associations are mediated by increased body mass index (BMI) and waist circumference, and higher resting heart rate, according to a study published online July 5 in Hypertension.
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Combination Therapy for A-Fib Increases Bleeding Risk
FRIDAY, July 8 (HealthDay News) -- Combination antithrombotic therapy for patients with atrial fibrillation (AF) is associated with an increased risk of bleeding and no reduction in the risk of stroke, according to a study published in the July issue of Chest.
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Delayed Disease Recognition in One in Five Patients With PAH
FRIDAY, July 8 (HealthDay News) -- One in five patients report symptoms of pulmonary arterial hypertension (PAH) for more than two years before the disease is diagnosed, with patients younger than 36 years being most likely to experience delayed recognition, according to a study published in the July issue of Chest.
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Stem Cells Reduce Angina Frequency in Refractory Angina
FRIDAY, July 8 (HealthDay News) -- Patients with refractory angina who receive injections of CD34+ cells experience a significant decrease in weekly angina frequency and improvement in exercise tolerance, according to a study published online July 7 in Circulation Research.
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Decrease in BP Precedes Death in Patients With Diabetes
FRIDAY, July 8 (HealthDay News) -- A significant decline in systolic and diastolic blood pressure (BP) is seen in the years preceding death in adults with diabetes, according to a study published in the July issue of Diabetes Care.
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Postpartum Contraceptive Use Guidelines Updated
THURSDAY, July 7 (HealthDay News) -- The use of combined hormonal contraceptives are not recommended during the first 21 days after delivery due to the high risk for venous thromboembolism (VTE), according to a report in the July 8 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
NSAIDs, COX-2 Inhibitors Tied to Increased Risk of A-Fib
THURSDAY, July 7 (HealthDay News) -- Use of non-aspirin, non-selective non-steroidal anti-inflammatory drugs (NSAIDs) or selective cyclooxygenase (COX) 2 inhibitors is associated with an increased risk of atrial fibrillation or flutter, according to a study published online July 4 in BMJ.
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Nesiritide Has Small, Nonsignificant Effect on Dyspnea
WEDNESDAY, July 6 (HealthDay News) -- Use of nesiritide has a small, nonsignificant effect on dyspnea in patients with acute heart failure, and is not associated with changes in rates of death and rehospitalizations, according to a study published in the July 7 issue of the New England Journal of Medicine.
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Sedentary Lifestyle Tied to Pulmonary Embolism Risk
WEDNESDAY, July 6 (HealthDay News) -- A sedentary lifestyle is associated with an increased risk of incident pulmonary embolism in women, according to a study published online July 4 in BMJ.
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Stroke Burden Shows Substantial Global Variation
WEDNESDAY, July 6 (HealthDay News) -- Stroke burden shows substantial global variation compared to ischemic heart disease (IHD), with countries with lower national income having disproportionately higher stroke death and disease burden than IHD, according to a study published online July 5 in Circulation.
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PCIs Done for Acute Indications Almost Always Appropriate
WEDNESDAY, July 6 (HealthDay News) -- Most percutaneous coronary interventions (PCIs) performed for acute indications are appropriate, but for nonacute indications the proportion of inappropriate PCIs is higher, with substantial between-hospital variations, according to a study published in the July 6 issue of the Journal of the American Medical Association.
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Low-Risk Lifestyle Linked to Lower SCD Risk Among Women
WEDNESDAY, July 6 (HealthDay News) -- Conforming to a low-risk lifestyle is associated with a decreased risk of sudden cardiac death (SCD) in women, according to a study published in the July 6 issue of the Journal of the American Medical Association.
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Fewer Clinical Capabilities in Critical Access Rural Hospitals
TUESDAY, July 5 (HealthDay News) -- Rural critical access hospitals (CAHs) have fewer clinical capabilities, significantly poorer performance on process measures, and higher 30-day mortality rates than non-CAHs for patients with acute myocardial infarction (AMI), congestive heart failure, and pneumonia, according to a study published in the July 6 issue of the Journal of the American Medical Association.
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Invasive Strategies Tied to Lower NSTEMI Mortality in CKD
TUESDAY, July 5 (HealthDay News) -- The management of non-ST-segment elevation myocardial infarction (NSTEMI) with invasive strategies (early invasive [EI] and deferred invasive [DI]) in patients with chronic kidney disease (CKD) is associated with significantly decreased mortality compared to a conservative strategy, except for patients with severe CKD, according to a study published in the July 15 issue of The American Journal of Cardiology.
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Increasing Incidence of U.S. In-Hospital Cardiac Arrests
TUESDAY, July 5 (HealthDay News) -- Approximately 200,000 patients are treated for in-hospital cardiac arrest (IHCA) annually in the United States, according to a study published online June 23 in Critical Care Medicine.
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Varenicline Use Linked to Adverse Cardiovascular Events
TUESDAY, July 5 (HealthDay News) -- Use of the smoking-cessation drug varenicline is associated with an increase in the risk of serious adverse cardiovascular events among tobacco users, according to a meta-analysis published online July 4 in CMAJ, the journal of the Canadian Medical Association.
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PCI Safe and Feasible in End-Stage Liver Disease
MONDAY, July 4 (HealthDay News) -- Percutaneous coronary intervention (PCI) for coronary artery disease (CAD) is safe and feasible for liver transplant candidates with end-stage liver disease (ESLD), according to a study published in the July issue of Liver Transplantation.
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Aspirin As Primary Prevention Strategy Investigated
FRIDAY, July 1 (HealthDay News) -- Aspirin may prevent the risk of total cardiovascular (CV) events and nonfatal myocardial infarctions (MI), but it does not significantly reduce the risk of stroke, CV mortality, all-cause mortality, or total coronary heart disease, according to a meta-analysis published in the June 15 issue of The American Journal of Cardiology.
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Older Breast Cancer Patients Likely to Die of Heart Disease
FRIDAY, July 1 (HealthDay News) -- Older women diagnosed with breast cancer are more likely to die from comorbid conditions, especially cardiovascular disease (CVD), rather than from breast cancer, according to a study published online June 20 in Breast Cancer Research.
Unprotected Left Main Coronary Artery PCI Safe, Effective
FRIDAY, July 1 (HealthDay News) -- For patients with normal left ventricular function, elective unprotected left main coronary artery (ULMCA) percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may be a safe and effective treatment, according to a study published in the June 1 issue of Catheterization & Cardiovascular Interventions.
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Pregravid Cardiometabolic Risk Factors Linked to GDM
FRIDAY, July 1 (HealthDay News) -- Women with pregravid cardiometabolic risk factors are at significantly higher risk of developing gestational diabetes mellitus (GDM), according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.
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Blood Pressure Variability Tied to Heart Surgery Mortality
FRIDAY, July 1 (HealthDay News) -- Variations in perioperative blood pressure are associated with 30-day mortality in cardiac surgical patients, with increased mortality risks for high-risk than low-risk patients, according to a study published in the July issue of Anesthesia & Analgesia.
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Gastric Bypass Tied to Lower Pro-Inflammatory Proteins
FRIDAY, July 1 (HealthDay News) -- Laparoscopic Roux-en-Y gastric bypass surgery (RYGB) reduces pro-inflammatory biomarkers and increases the levels of anti-inflammatory proteins, according to a study published online March 24 in Surgery for Obesity and Related Diseases.
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Comorbidities Negatively Affect Breast Cancer Survival
FRIDAY, July 1 (HealthDay News) -- The presence of comorbidities among older patients with early breast cancer is associated with either similar or worse overall survival than that of patients at a later stage of cancer with no comorbidities, according to a study published online June 30 in the Journal of the National Cancer Institute.
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