Here are what the editors at HealthDay consider to be the most important developments in Cardiology for June 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.
Group of Older Men Have Cardio Events With Testosterone Gel
WEDNESDAY, June 30 (HealthDay News) -- Older men with limited mobility have improved muscle strength but an increased risk of cardiovascular events when they receive testosterone gel supplementation, according to research published online June 30 in the New England Journal of Medicine.
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Consensus Formulation of CAV Nomenclature Issued
WEDNESDAY, June 30 (HealthDay News) -- The first international consensus formulation of a standardized nomenclature to define and describe post-heart-transplant cardiac allograft vasculopathy (CAV) has been issued by clinicians representing the International Society for Heart and Lung Transplantation Working Group on Classification of Cardiac Allograft Vasculopathy, and published in the July issue of the Journal of Heart and Lung Transplantation.
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Adult Obesity Rate Increases in 28 States
WEDNESDAY, June 30 (HealthDay News) -- In the past year, the adult obesity rate increased in 28 states, and there are marked differences in obesity rates by region, race, and income, according to a report published June 29 by the Trust for America's Health and the Robert Wood Johnson Foundation.
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Biomarker Aids in Heart Attack Risk Stratification
WEDNESDAY, June 30 (HealthDay News) -- Mid-regional pro-adrenomedullin (sAM) levels can predict mortality or heart failure in non-ST-elevation myocardial infarction (NSTEMI) patients, complementing other risk stratification tools, according to a study published in the July 6 issue of the Journal of the American College of Cardiology.
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Chronic Venous Insufficiency Common in Fontan Patients
WEDNESDAY, June 30 (HealthDay News) -- Among adult congenital heart disease patients with Fontan physiology, the prevalence of chronic venous insufficiency (CVI) is high, according to a study published in the July 6 issue of the Journal of the American College of Cardiology.
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Lower CYP2C19 Function Plus Clopidogrel May Cause Harm
TUESDAY, June 29 (HealthDay News) -- Patients treated with clopidogrel who are carriers of the loss-of-function CYP2C19*2 allele may be at increased risk for cardiovascular events and death, according to research published in the July 6 issue of the Journal of the American College of Cardiology.
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New Guidelines Issued for Clopidogrel After FDA Warning
TUESDAY, June 29 (HealthDay News) -- The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) released a joint clinical alert on June 28 to guide physicians in the interpretation of the boxed warning recently placed on the antiplatelet drug clopidogrel (Plavix) by the U.S. Food and Drug Administration. The full text of the alert will be co-published online June 28 in the Journal of the American College of Cardiology and Circulation.
Full Text - JACC
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Statins May Not Help High-Risk Patients With No CVD History
MONDAY, June 28 (HealthDay News) -- Statins do not appear to be associated with a reduced risk of death in people who are at increased risk for cardiovascular disease (CVD) but have no history of it, according to research published in the June 28 issue of the Archives of Internal Medicine.
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Doctors Agree Malpractice Fears Drive Overuse of Tests
MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.
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AHA Releases Guide for Cardiopulmonary Exercise Tests
MONDAY, June 28 (HealthDay News) -- In response to the increasing clinical value of cardiopulmonary exercise testing (CPX), the American Heart Association has developed the Clinician's Guide to Cardiopulmonary Exercise Testing in Adults to complement existing exercise testing guidelines with details on CPX. The new guide is being released as a scientific statement and published online June 28 in Circulation.
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Chronotropic Incompetence May Up Death Risk in Women
MONDAY, June 28 (HealthDay News) -- An attenuated heart rate response -- or chronotropic incompetence -- to exercise stress testing is linked to an increased risk of mortality in asymptomatic women, but the traditional calculation -- based on data from males -- overestimates women's maximum heart rate for age, according to a study published online June 28 in Circulation.
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Two Studies Demonstrate Cardiac Risks of Rosiglitazone
MONDAY, June 28 (HealthDay News) -- New evidence suggests that rosiglitazone is associated with an increased risk of adverse cardiovascular outcomes, according to two studies published online June 28 in the Journal of the American Medical Association and the Archives of Internal Medicine. The studies were released online ahead of publication because of their relevance to an upcoming U.S. Food and Drug Administration meeting intended to review the safety of rosiglitazone.
Abstract - Graham
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Abstract - Nissen/Wolski
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American Heart Association Comment
Venous Thromboembolism Risk Factors Vary by Race
MONDAY, June 28 (HealthDay News) -- Black Americans with venous thromboembolism (VTE) are less likely to have commonly recognized transient risk factors for the condition, are more likely to have cardiovascular disease risk factors, and are more likely to progress to pulmonary embolism than are white Americans, according to research published in the July issue of the American Journal of Hematology.
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Digoxin May Increase Mortality Risk in Hemodialysis Patients
FRIDAY, June 25 (HealthDay News) -- Digoxin use by patients on hemodialysis is linked to increased mortality, particularly in patients who have low pre-dialysis potassium concentrations, according to research published online June 24 in the Journal of the American Society of Nephrology.
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Statins May Lower Risk of Atrial Fibrillation in Heart Patients
FRIDAY, June 25 (HealthDay News) -- Statin therapy is associated with a reduced risk of developing atrial fibrillation (AF) among coronary artery disease patients, and lipid-lowering therapy (LLT) appears to reduce the risk of death and cardiovascular events among individuals who already have AF, according to research published in the June 15 issue of the American Journal of Cardiology.
Abstract - Kulik
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Abstract - Badheka
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Only 1 in 10 Meets '05 Sodium Intake Recommendations
THURSDAY, June 24 (HealthDay News) -- Only one in 10 American adults adheres to the 2005 recommendation for daily sodium intake, according to a report published in the June 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
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Prostate Cancer Endocrine Treatment Increases CVD Risk
THURSDAY, June 24 (HealthDay News) -- Men with prostate cancer who receive endocrine treatment (ET) have a modest increase in risk for cardiovascular disease (CVD), suggesting that clinicians should consider CVD risk when prescribing this treatment, according to a study published online June 21 in the Journal of Clinical Oncology.
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MRI Signs Predict Hypertrophic Cardiomyopathy Event Risk
THURSDAY, June 24 (HealthDay News) -- Visualization of cardiac scar tissue and gadolinium enhancement on cardiac magnetic resonance (CMR) imaging each predict an increased risk of a major cardiovascular event in patients with hypertrophic cardiomyopathy (HCM), according to two studies published online June 23 in the Journal of the American College of Cardiology.
Abstract - Bruder
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Abstract - O'Hanlon
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Folic Acid, B12 Do Not Reduce Vascular Events
TUESDAY, June 22 (HealthDay News) -- Supplementation with folic acid and vitamin B12 over an extended period does not have a beneficial effect on vascular outcomes in individuals who have had a myocardial infarction, but it also poses no excess cancer risk, according to a study in the June 23/30 issue of the Journal of the American Medical Association.
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Cardiology Practices With APNs, PAs Meet Guidelines
MONDAY, June 21 (HealthDay News) -- Cardiology practices with at least two advanced practice nurses (APNs) or physician assistants (PAs) on staff deliver most guideline-recommended heart failure outpatient therapies as well as practices with no APNs or PAs, and deliver some therapies and services better, according to a study in the June 15 issue of the American Journal of Cardiology.
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Post-Heart Attack Drinkers May Fare Better Than Quitters
MONDAY, June 21 (HealthDay News) -- Moderate drinkers who continue to drink after an acute myocardial infarction (AMI) do not appear to experience related adverse effects, and may even have better physical functioning than those who opt to quit drinking alcohol, according to a study in the June 15 issue of the American Journal of Cardiology.
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High Tea Consumption Linked to Lower CHD Mortality Risk
FRIDAY, June 18 (HealthDay News) -- Moderate coffee drinkers and moderate to heavy tea drinkers appear to experience less risk of heart disease and, in the case of tea drinkers, lower heart disease-related mortality, according to research published online June 18 in Arteriosclerosis, Thrombosis, and Vascular Biology.
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10 Risk Factors Associated With Most of Stroke Risk
FRIDAY, June 18 (HealthDay News) -- Worldwide, 10 risk factors are associated with 90 percent of the risk for stroke, suggesting that interventions targeting these particular factors could greatly reduce the stroke burden, according to a study published online June 18 in The Lancet.
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Gene Mutation Increases Clot Risk in Women on Tamoxifen
FRIDAY, June 18 (HealthDay News) -- Women taking adjuvant tamoxifen for early-stage breast cancer who develop a thromboembolism (TE) are nearly five times more likely to carry the factor V Leiden (FVL) mutation than women on the medication who don't have a TE, according to a study published online June 16 in the Journal of the National Cancer Institute.
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Bone Health Supplements Don't Increase Coronary Calcium
FRIDAY, June 18 (HealthDay News) -- Postmenopausal women who take calcium plus vitamin D supplements for bone health do not increase their levels of coronary artery calcium (CAC) and increase their cardiovascular disease risk as a result, according to a study published online June 14 in Menopause.
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Alternative Approach to Valve Replacement Surgery Effective
FRIDAY, June 18 (HealthDay News) -- Transcatheter valve-in-valve implantation may be an effective option for high-risk elderly patients with degenerated bioprostheses in the aortic and mitral position, according to a study published online April 30 in Catheterization & Cardiovascular Interventions.
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Outcomes Mixed on Different Stent Types in STEMI
THURSDAY, June 17 (HealthDay News) -- Patients with ST-segment elevation myocardial infarction (STEMI) who receive drug-eluting stents (DES) may have a lower rate of major adverse cardiac events than those who receive bare-metal stents (BMS), but they are more likely to experience cardiac death, according to research published online June 16 in the Journal of the American College of Cardiology.
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Zotarolimus Non-Inferior to Everolimus-Eluting Stents
WEDNESDAY, June 16 (HealthDay News) -- Zotarolimus-eluting stents are not inferior to everolimus-eluting stents in terms of clinical outcomes at 12 months or angiographic outcomes at 13 months, according to research published online June 16 in the New England Journal of Medicine.
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Mediterranean Diet Linked to Better Cardiac Function
WEDNESDAY, June 16 (HealthDay News) -- The closer a person conforms to a Mediterranean diet, the greater the likelihood of higher heart rate variability (HRV), indicating better cardiac autonomic function and lower risk for coronary artery disease, according to a study published online June 15 in Circulation: Cardiovascular Quality and Outcomes.
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HDL Cholesterol Inversely Associated With Cancer Risk
TUESDAY, June 15 (HealthDay News) -- Levels of high-density lipoprotein cholesterol (HDL-C) and incident cancer risk are significantly inversely associated, and this relationship is independent of factors such as low-density lipoprotein cholesterol (LDL-C), age, and smoking, according to research published in the June 22 issue of the Journal of the American College of Cardiology.
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Adolescent BP Predicts Hypertension in Young Adulthood
MONDAY, June 14 (HealthDay News) -- Blood pressure (BP) at age 17 rises over time in a linear fashion, and both male and female adolescents with BPs in the upper range of normal face more than double the risk of hypertension in young adulthood, according to research published online June 14 in Hypertension.
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ARBs Linked to Modestly Higher Risk of Cancer Diagnosis
MONDAY, June 14 (HealthDay News) -- Angiotensin-receptor blockers (ARBs) appear to be associated with a modest increase in risk of a new cancer diagnosis, according to research published online June 14 in The Lancet Oncology.
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Private Insurance Linked to Lower Hospital Mortality
FRIDAY, June 11 (HealthDay News) -- Patients with private insurance who are hospitalized for acute myocardial infarction (AMI), stroke or pneumonia have significantly lower in-hospital mortality than patients who are uninsured or have Medicaid, according to research published online June 10 in the Journal of Hospital Medicine.
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Medical and PCI Long-Term Outcomes Similar in CAD
FRIDAY, June 11 (HealthDay News) -- Coronary artery disease (CAD) patients who are either medically treated or treated with percutaneous coronary intervention (PCI) including stenting have similar long-term outcomes for mortality and nonfatal myocardial infarction, but the PCI group experiences less angina, according to a study in the June 1 issue of the American Journal of Cardiology.
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Aspirin Found Cost-Effective in Newly Diagnosed Diabetes
FRIDAY, June 11 (HealthDay News) -- In individuals age 40 and older who have been newly diagnosed with type 2 diabetes, regular aspirin use is a cost-effective strategy, according to a study in the June issue of Diabetes Care.
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Intensive Program Beats Usual Care for Diabetes Patients
THURSDAY, June 10 (HealthDay News) -- An intensive lifestyle intervention (ILI) program that restricts calories and increases exercise is able to improve cardiovascular disease (CVD) risk factors and reduce medication use and costs for individuals with type 2 diabetes better than usual care, according to a study in the June issue of Diabetes Care.
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Suppressed Anger in CAD Linked to Adverse Cardiac Events
THURSDAY, June 10 (HealthDay News) -- In patients with coronary artery disease (CAD), suppressing anger is associated with a higher risk of adverse cardiac events, according to research published in the June 1 issue of the American Journal of Cardiology.
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S. aureus Infections a Greater Risk After Certain Procedures
THURSDAY, June 10 (HealthDay News) -- The frequency and type of invasive Staphylococcus aureus infections following surgeries vary according to the type of procedure, with cardiothoracic and neurosurgical procedures linked to the highest risks, according to research published in the July issue of Infection Control & Hospital Epidemiology.
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No Increased Mortality Seen With Ultrasound Contrast Agent
THURSDAY, June 10 (HealthDay News) -- There is no increased mortality risk for critically ill patients who undergo echocardiography with an ultrasound contrast agent (UCA), compared to those who do not have contrast during their echocardiogram, according to research published in the June issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
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FDA: Defibtech's DBP-2800 Battery Packs Recalled
THURSDAY, June 10 (HealthDay News) -- Defibtech has alerted customers of a voluntary recall of 5,418 DBP-2800 Battery Packs used in the Lifeline Automatic External Defibrillator (AED) and ReviveR AED, as these AEDs may incorrectly recognize an error condition during charging for a shock and discontinue the charge, not providing therapy when the defected battery packs are used.
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Rate of Myocardial Infarction, 30-Day Mortality Decreasing
THURSDAY, June 10 (HealthDay News) -- The incidence of acute myocardial infarction (MI) has steadily decreased since 2000, and 30-day mortality has significantly decreased over the same time period, according to research published in the June 10 issue of the New England Journal of Medicine.
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Lack of Angina a Predictor for Mortality in CAD Patients
WEDNESDAY, June 9 (HealthDay News) -- In coronary artery disease (CAD) patients who undergo elective percutaneous intervention (PCI), mortality one year later is higher for those who don't have angina than for those who do have the symptom, according to a study in the June 1 issue of the American Journal of Cardiology.
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Short Stature Associated With Higher Heart Disease Risk
WEDNESDAY, June 9 (HealthDay News) -- Being short is associated with a higher risk of coronary heart disease morbidity and mortality than being tall, according to a systematic review and meta-analysis published online June 8 in the European Heart Journal.
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Abdominal Aortic Aneurysm Not Uncommon in CABG Patients
WEDNESDAY, June 9 (HealthDay News) -- Among patients who have undergone coronary artery bypass grafting (CABG), abdominal aortic aneurysms (AAAs) are particularly common in men with a history of smoking and other vascular problems, including peripheral arterial disease (PAD), according to research published in the June 1 issue of the American Journal of Cardiology.
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B Vitamins Show No Benefit in Slowing CAD Progression
WEDNESDAY, June 9 (HealthDay News) -- In patients with coronary artery disease (CAD) who have undergone percutaneous coronary intervention (PCI), subsequent therapy with folic acid/vitamin B12 lowers levels of total plasma homocysteine (tHcy) but does not have a beneficial effect on disease progression, according to a study in the June 1 issue of the American Journal of Cardiology.
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NSAID Cardio Risk for Healthy People Varies by Drug
WEDNESDAY, June 9 (HealthDay News) -- Use of the nonsteroidal anti-inflammatory drugs (NSAIDs) diclofenac and rofecoxib by healthy people is associated with an increased risk of cardiovascular death, but naproxen appears to have a safer cardiovascular risk profile, according to a study published online June 8 in Circulation: Cardiovascular Quality and Outcomes.
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Fatal Medication Errors Rise in July at Teaching Hospitals
TUESDAY, June 8 (HealthDay News) -- In July there is a significant increase in fatal medication errors at medical institutions, and this spike is at least partly due to the arrival of new medical residents, according to a study published online May 29 in the Journal of General Internal Medicine.
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Risk Factors Up Odds of Plaque Progression Despite Low LDL
TUESDAY, June 8 (HealthDay News) -- Several independent risk factors, including baseline percent atheroma volume (PAV) and the presence of diabetes, are associated with the likelihood of continued progression of disease in individuals who have achieved very low levels of low-density lipoprotein cholesterol (LDL-C), according to research published in the June 15 issue of the Journal of the American College of Cardiology.
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Gout Drug Effective and Safe in Chronic Stable Angina
TUESDAY, June 8 (HealthDay News) -- Allopurinol, a standard treatment for gout, appears to be effective and safe in prolonging exercise capacity in patients with chronic stable angina, according to a study published online June 8 in The Lancet.
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Many Hospital Patients Readmitted Within Two Years
MONDAY, June 7 (HealthDay News) -- Approximately 25 percent of hospital patients were readmitted to the hospital within a two-year period for the same conditions that prompted their initial admission, according to a recent report from the Agency for Healthcare Research and Quality (AHRQ).
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Low-Dose Estrogen Patch Linked to Lower Risk of Stroke
FRIDAY, June 4 (HealthDay News) -- Postmenopausal women who use low-dose estrogen transdermal patches have a lower risk of stroke compared to users of either high-dose estrogen patches or oral hormone replacement therapy (HRT), according to research published June 3 in BMJ.
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Non-Married at Greater Risk of Hospitalization for Sepsis
FRIDAY, June 4 (HealthDay News) -- Single, separated, and widowed adults have a higher risk of hospitalization for sepsis than do their married peers, and some face higher mortality rates as well, according to research published in the June issue of Chest.
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Many Ischemic Stroke Patients Arrive at ER Within Hour
FRIDAY, June 4 (HealthDay News) -- A substantial portion of ischemic stroke patients present to emergency departments within an hour of onset, and they are more likely to receive thrombolytic therapy than those who arrive later, but both factors present room for improvement, according to research published online June 3 in Stroke.
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Low HDL Predicts Development of Abdominal Aortic Aneurysm
FRIDAY, June 4 (HealthDay News) -- There appears to be a consistent association between low levels of high-density lipoprotein (HDL) and the presence of abdominal aortic aneurysms (AAAs) in men aged 65 years or older, according to research published in the May 15 issue of the American Journal of Cardiology.
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LDL Increase on Omega-3 Plus Simvastatin Only in Subgroup
FRIDAY, June 4 (HealthDay News) -- The increase in low-density lipoprotein (LDL) cholesterol that occurs with the addition of omega-3 treatment to simvastatin appears to happen mainly in those with low baseline LDL while on simvastatin alone, according to research published in the May 15 issue of the American Journal of Cardiology.
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Caregiving Stress May Impair Endothelial Function
THURSDAY, June 3 (HealthDay News) -- The stress of caring for a spouse with Alzheimer's disease may increase the risk of cardiovascular events due to impaired endothelial functioning, according to research published in the June 8 issue of the Journal of the American College of Cardiology.
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Early Heparin Beneficial in Pulmonary Embolism
THURSDAY, June 3 (HealthDay News) -- For patients with acute pulmonary embolism (PE), starting heparin early, while the patient is still in the emergency department, is associated with decreased mortality, according to research published in the June issue of Chest.
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Stenting Safe Alternative to CABG in ULMCA Stenosis
THURSDAY, June 3 (HealthDay News) -- In patients with unprotected left main coronary artery (ULMCA) stenosis and additional vascular disease, coronary stenting is probably a safe alternative to coronary artery bypass graft (CABG), according to research published in the June 8 issue of the Journal of the American College of Cardiology.
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Stroke Patients Benefit From Early Lipid-Lowering Therapy
THURSDAY, June 3 (HealthDay News) -- Early initiation of lipid-lowering therapy (LLT) during hospitalization for ischemic stroke or transient ischemic attack correlates with improved clinical outcomes, according to research published in the May 15 issue of the American Journal of Cardiology.
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Moms' Weight Before, During Pregnancy Tied to Kids' Issues
WEDNESDAY, June 2 (HealthDay News) -- Higher pre-pregnancy weight and gestational weight gain (GWG) up to 36 weeks are linked to adverse cardiovascular risk factors and adiposity in offspring, according to research published online June 1 in Circulation.
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3-D Echo With Contrast Shows Promise for Infarct Scars
WEDNESDAY, June 2 (HealthDay News) -- Contrast-enhanced 3-D echocardiography may be a useful tool for detecting and assessing myocardial infarct scars, according to research published online June 1 in Circulation: Cardiovascular Imaging.
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Risk Score Predicts Bleeding in Acute Coronary Syndromes
WEDNESDAY, June 2 (HealthDay News) -- Researchers have developed and tested a practical risk score designed to predict the risk and implications of major bleeding in acute coronary syndromes (ACS), and have found it effective for identifying at-risk patients, according to research published in the June 8 issue of the Journal of the American College of Cardiology.
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Physical Activity in Young Tied to Incident Hypertension
WEDNESDAY, June 2 (HealthDay News) -- Maintaining physical fitness and being physically active at a young age are each independently associated with a reduced risk of eventually developing hypertension, according to research published online June 1 in Hypertension.
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Ultrasound Identifies Patients at Higher Stroke Risk
WEDNESDAY, June 2 (HealthDay News) -- The detection of asymptomatic embolic signals using transcranial doppler (TCD) may help identify groups of patients with asymptomatic carotid stenosis who are at low or high risk of stroke, which could be useful in identifying those most likely to benefit from endarterectomy, according to a study published online May 28 in The Lancet Neurology to coincide with its presentation at the European Stroke Conference, held from May 25 to 28 in Barcelona, Spain.
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Post-CPR Hyperoxia Linked to Higher Mortality Risk
TUESDAY, June 1 (HealthDay News) -- Both hyperoxia after cardiopulmonary resuscitation (CPR) and non-adherence to recommended timing of interventions after ST-elevation myocardial infarction (STEMI) result in significant increases in mortality, according to two studies published in the June 2 issue of the Journal of the American Medical Association.
Abstract - Kilgannon
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Abstract - Lambert
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In Heart Failure, Discharges Earlier, Readmission Rates Up
TUESDAY, June 1 (HealthDay News) -- Patients admitted to hospitals for heart failure in 2006 fared better in-hospital than did those in 1993, but were discharged more often to nursing homes, and readmitted more frequently, according to research published in the June 2 issue of the Journal of the American Medical Association.
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Combination Strategy Best for Bleeding Prevention After PCI
TUESDAY, June 1 (HealthDay News) -- Patients undergoing percutaneous coronary intervention (PCI) who get bivalirudin in addition to a vascular closure device have the lowest bleeding risk, but patients with a high preprocedural bleeding risk are less likely to receive this treatment, according to research published in the June 2 issue of the Journal of the American Medical Association.
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Cardiac Arrest, CPR Attempts Vary by Neighborhood
TUESDAY, June 1 (HealthDay News) -- Some neighborhoods consistently have more cardiac arrests than others and fewer bystanders who attempt to perform emergency cardiopulmonary resuscitation (CPR), according to research published online June 1 in the Annals of Internal Medicine.
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Heart Fatty Acid-Binding Protein Levels May Indicate ACS Risk
TUESDAY, June 1 (HealthDay News) -- Obtaining the concentration of heart fatty acid-binding protein (H-FABP) in patients with suspected acute coronary syndrome (ACS) may help physicians identify high-risk patients who are troponin-negative, according to research published in the June 8 issue of the Journal of the American College of Cardiology.
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Ambulatory Cardiac Telemetry Detects Serious Arrhythmias
TUESDAY, June 1 (HealthDay News) -- Ambulatory cardiac telemetry may provide clinical information that could potentially be lifesaving in patients with serious arrhythmic events, according to research published in the May 1 issue of the American Journal of Cardiology.
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