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June 2006 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for June 2006. 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.

Netrins May Spur Blood Vessels in Ischemia, Diabetes

FRIDAY, June 30 (HealthDay News) -- Researchers have found that the developmental signaling molecules called netrins, previously shown to direct neuron migration, also help form new blood vessels, according to a report published June 29 in Sciencexpress, the early edition of Science. The molecules boosted capillary growth in animal models of ischemia and diabetes.

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Treatment Improves Motor Function in Stroke Patients

THURSDAY, June 29 (HealthDay News) -- In stroke patients, five consecutive sessions of transcranial magnetic stimulation (rTMS) treatment improves motor function without causing adverse cognitive effects of epileptogenic activity, according to a report published online June 30 in Stroke.

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New MRI Technique Identifies Blocked Coronary Arteries

THURSDAY, June 29 (HealthDay News) -- A new non-invasive cardiac magnetic resonance imaging (MRI) technique -- which combines stress first-pass perfusion MRI with delayed contrast enhancement -- is highly accurate in showing blockage of the coronary arteries, according to a study in the July issue of Radiology.

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Women's In-Hospital Survival Up for Heart Disease, Stroke

THURSDAY, June 29 (HealthDay News) -- Between 2002 and 2004, women's in-hospital survival rates for heart disease and stroke improved by an average of 9.54 percent, and the best-performing hospitals had a 40 percent lower mortality rate than the poorest-performing hospitals, according to the Third Annual Report on Women's Health Outcomes in U.S. Hospitals study published June 26 by HealthGrades.

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Antioxidant May Cut Contrast Dye-Induced Nephropathy

WEDNESDAY, June 28 (HealthDay News) -- In myocardial infarction patients undergoing primary angioplasty, intravenous and oral doses of the antioxidant N-acetylcysteine may help prevent contrast-medium-induced nephropathy and improve outcomes, according to a study published in the June 29 issue of the New England Journal of Medicine.

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Reducing Homocysteine Does Not Improve Cognition

WEDNESDAY, June 28 (HealthDay News) -- In healthy older people, B-vitamin therapy to reduce blood levels of homocysteine does not appear to improve cognitive function, according to a study in the June 29 issue of the New England Journal of Medicine.

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Low-Fat Dairy Products May Help Prevent Hypertension

WEDNESDAY, June 28 (HealthDay News) -- Consuming low-fat dairy products may help prevent hypertension, according to a report published online June 26 in Hypertension.

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Nighttime Blood Pressure May Predict Heart Failure

WEDNESDAY, June 28 (HealthDay News) -- Elderly men with a nighttime blood pressure that stays the same or increases compared with the daytime pressure have more than twice the risk of developing heart failure, according to a report in the June 28 issue of the Journal of the American Medical Association.

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Boston Scientific Recalls Pacemakers and Defibrillators

TUESDAY, June 27 (HealthDay News) -- Boston Scientific Corporation has recalled a subset of cardiac devices including Insignia and Nexus pacemakers, Contak Renewal TR/TR2 cardiac resynchronization pacemakers and Ventak Prizm 2, Vitality and Vitality 2 implantable cardioverter defibrillators, manufactured by the company's Cardiac Rhythm Management (CRM) Group. The group was formerly Guidant's CRM business, acquired by Boston Scientific in April this year.

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Viagra Helps Cyclists' Exercise Performance at High Altitude

TUESDAY, June 27 (HealthDay News) -- Sildenafil (Viagra) may improve exercise performance in men cycling at conditions similar to those found at high altitudes, but does not affect performance at sea level, according to a report in the June issue of the Journal of Applied Physiology.

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NEJM Issues Correction on 2005 Vioxx Study

MONDAY, June 26 (HealthDay News) -- The New England Journal of Medicine has issued a correction to the Adenomatous Polyp Prevention on Vioxx (APPROVe) trial, a 2005 publication that suggested that thrombotic events in rofecoxib-treated patients only diverged from placebo after 18 months of treatment. However, an error in the analysis now indicates that adverse events diverged from the placebo group prior to 18 months, the authors report.

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QT Prolongation Linked to Methadone Therapy

MONDAY, June 26 (HealthDay News) -- Intravenous drug users who receive methadone maintenance therapy to curb their habit are at an increased risk for developing long QT syndrome, according to a report in the June 26 Archives of Internal Medicine.

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ACE Inhibitor Helps Heart Patients With Kidney Problems

MONDAY, June 26 (HealthDay News) -- The angiotensin-converting enzyme (ACE) inhibitor trandolapril may improve survival for some heart patients with kidney problems, according to a report published online June 26 in Circulation: Journal of the American Heart Association.

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First Generic Version of Simvastatin Gets FDA Approval

MONDAY, June 26 (HealthDay News) -- The U.S. Food and Drug Administration has approved the first generic version of simvastatin (Zocor), the second most widely prescribed statin in the United States, to treat hypercholesterolemia. The FDA also recently approved generic versions of Proscar, Propecia and Lamictal.

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Job Loss Later in Life Doubles Myocardial Infarction Risk

MONDAY, June 26 (HealthDay News) -- Patients who lose their jobs after the age of 50 are at double the risk of myocardial infarction and stroke compared to their employed counterparts, according to a study published online June 23 in Occupational and Environmental Medicine.

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Family History Linked to Heart Risk in Rheumatoid Arthritis

FRIDAY, June 23 (HealthDay News) -- Rheumatoid arthritis patients have a higher risk of cardiovascular disease than the general population, but the risk is even higher if they have a family history of heart disease, according to a report in the June issue of the Annals of the Rheumatic Diseases.

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Digoxin-Like Compound Protects Rat Brains from Stroke

FRIDAY, June 23 (HealthDay News) -- A compound similar to cardiac glycosides such as digitoxin and digoxin, which are used to treat congestive heart failure and arrhythmias, can protect the brain cells of rats from the effects of a stroke, according to a study published online June 22 in the Proceedings of the National Academy of Sciences Early Edition.

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Ablation Cost-Effective for Some Atrial Fibrillation Patients

THURSDAY, June 22 (HealthDay News) -- Left atrial catheter ablation (LACA) can be cost effective for atrial fibrillation patients in their 50s and 60s if they have a moderate, but not low, stroke risk, according to a report in the June 20 issue of the Journal of the American College of Cardiology.

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Freshness of Blood Can Affect Cardiac Surgery Outcome

THURSDAY, June 22 (HealthDay News) -- The freshness of blood used in transfusion during reoperative cardiac surgery can have an impact on the outcome, according to a study published in the July 1 issue of Anesthesia & Analgesia.

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Ultramarathon Can Cause Exertional Rhabdomyolysis

THURSDAY, June 22 (HealthDay News) -- Prolonged, moderate intensity exercise experienced by ultramarathon runners may cause a significant rise in indicators of muscle and liver damage and cause serum enzyme activity changes similar to those which occur in an acute myocardial infarction, according to a report in the June issue of Medicine & Science in Sports & Exercise. However, this rise in creatine kinase and other factors is not accompanied by severe symptoms that require hospitalization, they note.

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Intravascular Ultrasound Identifies Plaque Components

THURSDAY, June 22 (HealthDay News) -- Intravascular ultrasound radiofrequency (IVUS RF) backscatter analysis, a color-coded mapping method, accurately identifies atherosclerotic plaque components that may be likely to rupture, according to a study in the June 20 issue of the Journal of the American College of Cardiology.

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ACE Gene Variants Linked to Muscle Response to Training

THURSDAY, June 22 (HealthDay News) -- Polymorphisms in the angiotensin I-converting enzyme (ACE) gene predict muscle growth and strength response to resistance training but mostly in untrained muscles, according to a report in the June issue of Medicine & Science in Sports & Exercise.

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Cheap Pedometers Tend to Inaccurately Record Steps

THURSDAY, June 22 (HealthDay News) -- Pedometers have become widely available, but many cheaper models are not useful for health purposes because they do not accurately monitor the steps taken, according to a study published online June 21 in the British Journal of Sports Medicine.

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Deaths in College Athletes Can Occur Despite Rapid Aid

THURSDAY, June 22 (HealthDay News) -- An analysis of nine college athletes who experienced sudden cardiac arrest suggests about half had structural heart defects and most died despite rapid cardiopulmonary resuscitation and use of a defibrillator, according to a study in the July issue of Heart Rhythm.

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Gene Mutations Play Role in Idiopathic Atrial Fibrillation

WEDNESDAY, June 21 (HealthDay News) -- Mutations in the gene that codes for the connexin 40 protein found in the gap junctions of atrial myocytes can be found in about a quarter of patients with idiopathic atrial fibrillation, according to a study in the June 22 issue of the New England Journal of Medicine.

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Filter with Carotid Stenting May Benefit High-Risk Patients

WEDNESDAY, June 21 (HealthDay News) -- A distal embolic protection system that utilizes a filter may be an alternative way to perform carotid artery stenting in patients who are too high-risk for endarterectomy, according to a study published in the June 20 issue of the Journal of the American College of Cardiology.

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Statin Use May Lower Risk of Nuclear Cataracts

TUESDAY, June 20 (HealthDay News) -- The use of statins as lipid-lowering agents may also prevent age-related nuclear cataracts due to the drugs' putative antioxidant properties, according to a report in the June 21 issue of the Journal of the American Medical Association.

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Company-Sponsored Trials Affect Physician Choice of Meds

TUESDAY, June 20 (HealthDay News) -- Physicians participating in a company-sponsored clinical trial are not likely to stray from recommended treatment guidelines but they do tend to prescribe more of the company's drugs, according to a report in the June 21 issue of the Journal of the American Medical Association.

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Brief CPAP Does Not Ease Hypertension in Sleep Apnea

MONDAY, June 19 (HealthDay News) -- Short-term continuous positive airway pressure (CPAP) does not significantly alleviate high blood pressure in patients with arterial hypertension and obstructive sleep apnea syndrome, according to a report in the June issue of Chest.

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AHA Revises Diet and Lifestyle Recommendations

MONDAY, June 19 (HealthDay News) -- Eating oily fish at least twice a week is among the guidelines that the American Heart Association (AHA) has underscored for reducing the risk of cardiovascular disease, according to a scientific statement published online June 19 in Circulation: Journal of the American Heart Association.

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High-Dose Cox-2 Inhibitors, NSAIDs Risky for MI Patients

MONDAY, June 19 (HealthDay News) -- In patients who have previously had a myocardial infarction (MI), the use of high dosages of selective cyclooxygenase-2 (COX-2) inhibitors and other nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) carries an increased risk of mortality, according to a study published online June 19 in Circulation: Journal of the American Heart Association.

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Type 2 Diabetes Incidence Doubles in the Middle-Aged

MONDAY, June 19 (HealthDay News) -- New cases of type 2 diabetes in middle-aged Americans have doubled in the past 30 years, with most of the increase attributable to a rise in those with a high body mass index, according to a study in the June 19 issue of Circulation: Journal of the American Heart Association.

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Letrozole for Infertility Appears Non-Teratogenic

MONDAY, June 19 (HealthDay News) -- Newborns whose mothers conceived after fertility treatment with letrozole or clomiphene citrate (CC) show no group differences in overall rates of major and minor congenital malformations, while cardiac anomaly may be more frequent in those whose mothers were treated with CC, according to a study in the June issue of Fertility and Sterility.

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Vegetable-Rich Diet Blocks Atherosclerosis in Mice

MONDAY, June 19 (HealthDay News) -- A diet rich in green and yellow vegetables reduces atherosclerosis by 38 percent in mice prone to developing the disease, according to a study in the July issue of the Journal of Nutrition.

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New Guidelines Issued for Valvular Heart Disease

FRIDAY, June 16 (HealthDay News) -- Major advances in non-invasive testing and surgery for patients with valvular heart disease are addressed in updated guidelines jointly released June 16 by the American College of Cardiology and the American Heart Association.

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Pregnancy Outcomes Worse in Diabetic Than Other Women

FRIDAY, June 16 (HealthDay News) -- Infants born to women with type 1 or type 2 diabetes have perinatal mortality rates and major congenital anomaly rates about four times and more than two times higher, respectively, than infants in the general population, according to a study published online June 16 in BMJ.

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Statin Dose Cuts Cardiac Events 25 Percent in Diabetics

THURSDAY, June 15 (HealthDay News) -- High doses of the lipid-lowering drug atorvastatin cut major cardiovascular events in diabetics with stable coronary heart disease by one-quarter, according to a report in the June issue of Diabetes Care.

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Ischemia Preconditioning Helps Children in Heart Surgery

WEDNESDAY, June 14 (HealthDay News) -- Preconditioning children about to undergo cardiac surgery by temporarily blocking blood flow to their legs and inducing ischemia-reperfusion may offer a protective effect against ischemia-related damage during the procedure, according to a report in the June 6 issue of the Journal of the American College of Cardiology.

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Study Groups Disagree on Use of Automatic CPR Device

TUESDAY, June 13 (HealthDay News) -- Two studies comparing the use of an automatic cardiopulmonary resuscitation (CPR) device and manual CPR for out-of-hospital cardiac arrests have conflicting results, with one suggesting potentially worse outcome with the automatic device and the other showing a benefit, according to reports in the June 14 Journal of the American Medical Association.

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Fish Oil Doesn't Protect Cardiac Patients from Arrhythmias

TUESDAY, June 13 (HealthDay News) -- Fish oil supplements do not protect patients with an implantable cardioverter defibrillator from developing abnormal heart rhythms, according to results from the European Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) reported in the June 14 issue of the Journal of the American Medical Association.

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Meditation Shows Promise for Heart Disease Patients

TUESDAY, June 13 (HealthDay News) -- Transcendental meditation can improve blood pressure and insulin resistance components of the metabolic syndrome in patients with coronary heart disease (CHD), according to a report in the June 12 issue of the Archives of Internal Medicine.

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Implantable Defibrillators Boost Survival, Heart Failure

TUESDAY, June 13 (HealthDay News) -- Patients with chronic ischemic heart disease have improved chances of survival when treated with either single-chamber or dual-chamber implantable cardioverter-defibrillators (ICDs), but as they live longer, they have an almost fourfold risk of developing heart failure, according to a study in the June 20 issue of Circulation: Journal of the American Heart Association.

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One in Seven with Stent Prematurely Stop Medication

MONDAY, June 12 (HealthDay News) -- Almost one of every seven myocardial infarction patients prematurely discontinues thienopyridine therapy after receiving a drug-eluting stent (DES), increasing their risk of death ninefold, according to a study published in the June 20 issue of Circulation: Journal of the American Heart Association.

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Aortic Stenosis May Be Linked to Atherosclerosis

MONDAY, June 12 (HealthDay News) -- Aortic stenosis progresses more quickly in patients who also have metabolic syndrome, suggesting that aortic stenosis is an active process mediated by many of the same factors that influence atherosclerosis, according to a report in the June 6 issue of the Journal of the American College of Cardiology.

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Reminders Prompt Physicians to Prescribe Best BP Drugs

FRIDAY, June 9 (HealthDay News) -- Physicians who receive pharmacist visits and subsequent computer reminders are more likely to prescribe less expensive and guideline-recommended antihypertensive drugs compared with those who only receive prescribing guidelines, according to a study published in the June issue of PLoS Medicine.

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Warfarin Best at Stroke Prevention in Atrial Fibrillation

FRIDAY, June 9 (HealthDay News) -- In patients with atrial fibrillation, anticoagulants such as warfarin continue to be the gold-standard treatment for preventing stroke, according to a study published in the June 10 issue of The Lancet, which was halted early due to the superiority of the oral anticoagulant.

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New Tool Improves Ethnic Group Heart Risk Assessment

FRIDAY, June 9 (HealthDay News) -- A new risk score helps more accurately predict the risk of cardiovascular disease and 10-year coronary heart disease risk for seven black and minority ethnic groups, according to a U.K. study published online June 8 in Heart.

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Protein May Be Marker for Stroke Risk

FRIDAY, June 9 (HealthDay News) -- Pregnancy-associated plasma protein A (PAPP-A) is found at high levels in the serum and carotid plaques of patients with vulnerable or ruptured plaques and may be useful in estimating stroke risk, according to a study in the June 6 issue of the Journal of the American College of Cardiology. PAPP-A is found in both men and women, but is elevated in pregnancy.

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Yellow Arterial Plaque Predicts Risk of Coronary Events

THURSDAY, June 8 (HealthDay News) -- Patients with two or more yellow plaques per coronary artery have at least twice the risk of developing an acute coronary syndrome event as patients who have fewer or none of this type of plaque, according to a study in the June 6 issue of the Journal of the American College of Cardiology.

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Birth Defects Higher After ACE Inhibitor Use in 1st Trimester

WEDNESDAY, June 7 (HealthDay News) -- Women who take angiotensin-converting-enzyme (ACE) inhibitors during the first trimester of pregnancy have a greater risk of having an infant with major congenital malformations than women who do not take the antihypertensives, according to a report in the June 8 issue of the New England Journal of Medicine.

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Long-Term Compliance Good After Myocardial Infarction

WEDNESDAY, June 7 (HealthDay News) -- When patients are started on beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and statins soon after an acute myocardial infarction, they are likely to continue taking the medications for many years. But the dosages they receive may be suboptimal, according to a study published in the May issue of the European Heart Journal.

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Stem Cell Niches Identified in Heart Muscle of Mice

WEDNESDAY, June 7 (HealthDay News) -- Researchers have found niches in the mouse heart where cardiac stem cells reside, providing further evidence that heart muscle can be replenished, according to a report published online June 5 in the Proceedings of the National Academy of Sciences Early Edition. Cardiac stem cell generation occurs throughout the myocardium, but is highest in the apex and atria, and slower at the base-midregion of the ventricle.

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Online Course Launched to Focus on Gender, Health Issues

WEDNESDAY, June 7 (HealthDay News) -- The U.S. Food and Drug Administration Office of Women's Health and the National Institutes of Health Office of Research on Women's Health have launched a new online course that is aimed at clinicians and highlights how illness and health outcomes differ between males and females.

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Revascularization Boosts Survival in Cardiogenic Shock

TUESDAY, June 6 (HealthDay News) -- Early revascularization after acute myocardial infarction complicated by cardiogenic shock results in a 13 percent improvement in survival after six years compared with initial medical stabilization, according to a study in the June 7 issue of the Journal of the American Medical Association.

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Nap Schedule May Reduce Fatigue in Medical Residents

TUESDAY, June 6 (HealthDay News) -- A protected nap schedule for medical residents covering overnight shifts only modestly increases sleep time but reduces reports of fatigue and sleepiness, according to a study in the June 6 issue of the Annals of Internal Medicine.

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High Temperatures Increase Risk of Death By a Third

TUESDAY, June 6 (HealthDay News) -- High temperatures can increase the overall risk of death by about a third, with the elderly, women, widows, widowers and those with certain medical conditions being most vulnerable, according to a study in the May issue of Epidemiology.

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Female Cardiac Rehabilitation Patients Less Fit Than Men

MONDAY, June 5 (HealthDay News) -- Women entering a rehabilitation program who experienced a recent myocardial infarction or had bypass surgery are about as fit as patients with life-threatening chronic heart failure, according to a study published online June 5 in Circulation: Journal of the American Heart Association.

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Patients Assess Family History for High Cholesterol Risk

MONDAY, June 5 (HealthDay News) -- After diagnosis, patients perceive their own risk from a genetic disease like hypercholesterolemia by considering their family history of the disease rather than information about generalized risk, according to a report in the May/June issue of the Annals of Family Medicine. Physicians should use this information to tailor medical treatment for these patients.

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Meta-Analysis Finds COX-2 Inhibitors, NSAID Risk Similar

FRIDAY, June 2 (HealthDay News) -- Selective COX-2 inhibitors and high doses of some traditional nonsteroidal anti-inflammatory drugs (NSAIDs) carry similar risks of cardiovascular events such as myocardial infarction, according to a meta-analysis published in the June 3 issue of BMJ.

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Chronic Kidney Disease Linked to Cardiovascular Disease

FRIDAY, June 2 (HealthDay News) -- Chronic kidney disease is strongly associated with risk for myocardial infarction and cardiovascular disease-related mortality, according to the May issue of the European Heart Journal.

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Left Ventricular Dysfunction a Risk Factor for Stroke

THURSDAY, June 1 (HealthDay News) -- Ischemic stroke patients are almost four times more likely to have left ventricular dysfunction (LVD) compared with healthy controls, and even mild, symptom-free impaired heart function increases the risk of stroke, according to a study published online June 1 in Stroke.

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Aortic Debris Not a Risk Factor for Stroke

THURSDAY, June 1 (HealthDay News) -- The presence of aortic debris is not an independent risk factor for cryptogenic ischemic stroke or transient ischemic attack, according to a study in the May issue of the Mayo Clinic Proceedings.

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New Tool Predicts 10-Year Heart Risk in Type 2 Diabetics

THURSDAY, June 1 (HealthDay News) -- A pen-and-paper estimator of 10-year coronary heart disease (CHD) risk for type 2 diabetics accurately predicts CHD in four out of five cases, researchers report in the May issue of the Mayo Clinic Proceedings.

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