November 2006 Briefing - Cardiology

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

Left Ventricle Size, Function Linked to Risk Factors

THURSDAY, Nov. 30 (HealthDay News) -- Modifiable cardiovascular risk factors are associated with subclinical changes in left ventricular geometry and function as measured by magnetic resonance imaging, researchers report in the Dec. 5 issue of the Journal of the American College of Cardiology. For example, smokers and diabetics without cardiovascular disease have higher left ventricular mass, lower stroke volume and lower ejection fractions than other patients.

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Exercise May Curb Snoring in Overweight Children

THURSDAY, Nov. 30 (HealthDay News) -- Energetic aerobic exercise helps control snoring and general sleep-disordered breathing problems in overweight children, researchers report in the November issue of Obesity.

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Procyanidins in Red Wine May Be Key to Healthy Heart

THURSDAY, Nov. 30 (HealthDay News) -- Red wine rich in polymeric procyanidins, a subgroup of heart healthy polyphenols, may be best at improving the condition of blood vessels and lowering mortality, according to a brief communication in the Nov. 30 issue of Nature.

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Cutting Smoking in Half Doesn't Impact Early Death

WEDNESDAY, Nov. 29 (HealthDay News) -- Reducing cigarette consumption by more than 50 percent does not significantly lower the risk for all-cause mortality, death due to cardiovascular disease or smoking-related cancer for men and women, according to a report in the December issue of Tobacco Control.

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FDA Issues Warning About Methadone

TUESDAY, Nov. 28 (HealthDay News) -- The U.S. Food and Drug Administration has issued a public health advisory warning to health care professionals prescribing methadone hydrochloride (Dolophine). Death and life-threatening side effects, such as severe respiratory problems and cardiac arrhythmias, have occurred in patients prescribed the drug for new pain, or who are being switched from other narcotic pain relievers.

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Inhibitors Prevent and Treat Cardiac Hypertrophy in Mice

TUESDAY, Nov. 28 (HealthDay News) -- Soluble epoxide hydrolase inhibitors can prevent and reverse cardiac hypertrophy in mice as well as prevent cardiac arrhythmias, according to study findings published online Nov. 27 in the Proceedings of the National Academy of Sciences Early Edition.

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New, Not Recurrent, Depression a Risk After Myocardial Infarction

TUESDAY, Nov. 28 (HealthDay News) -- Only patients who develop a new episode of depression in the year after a myocardial infarction have an elevated risk of new cardiovascular events compared with non-depressed patients, researchers report in the Dec. 5 issue of the Journal of the American College of Cardiology. Those with ongoing or recurrent depression are at no greater risk than other patients.

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Statins for Primary Prevention Don't Reduce Mortality

MONDAY, Nov. 27 (HealthDay News) -- Although statin therapy decreases major coronary and cerebrovascular events and revascularization procedures, it does not decrease all-cause mortality or death due to coronary heart disease in patients who do not have cardiovascular disease, according to study results published in the Nov. 27 Archives of Internal Medicine.

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Heart Attack Care Substandard in Medicaid Patients

FRIDAY, Nov. 24 (HealthDay News) -- Among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), those on Medicaid receive lower-quality care and experience worse outcomes than those with HMOs or private insurance, according to study findings published in the Nov. 21 issue of the Annals of Internal Medicine.

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Bivalirudin Monotherapy Benefits Cardiac Patients

WEDNESDAY, Nov. 22 (HealthDay News) -- In patients with moderate- or high-risk acute coronary syndromes, treatment with bivalirudin alone is associated with similar rates of ischemia, significantly lower rates of bleeding and an improved net outcome compared to heparin plus glycoprotein IIb/IIIa inhibitors, according to a study in the Nov. 23 issue of the New England Journal of Medicine.

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Cardiac-Specific Stem Cells Isolated from Mice

WEDNESDAY, Nov. 22 (HealthDay News) -- Researchers have isolated cells from mouse embryonic stem cells that can differentiate into various types of cells found in the heart, which may someday allow more safe and targeted regeneration of heart structures, according to two studies published online Nov. 22 in Cell.

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Oral Rinse Cuts Nosocomial Infection After Cardiac Surgery

TUESDAY, Nov. 21 (HealthDay News) -- Cardiac surgery patients who undergo chlorhexidine gluconate decontamination of the nasopharynx and oropharynx have lower rates of post-surgery nosocomial infections, including lower respiratory tract and surgical site infections, according to the results of a study published in the Nov. 22/29 issue of the Journal of the American Medical Association.

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DHA Levels in Older Adults May Predict Dementia Risk

TUESDAY, Nov. 21 (HealthDay News) -- Older adults with high plasma levels of docosahexaenoic acid, or DHA, may have a significantly lower risk of developing dementia and Alzheimer disease, according to a study in the November issue of the Archives of Neurology.

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Younger Stroke Survivors Face Health Care Barriers

MONDAY, Nov. 20 (HealthDay News) -- Younger stroke survivors may have less access to medical care, medications and health insurance than their counterparts who are 65 and older, according to study findings published online Nov. 13 in the Archives of Neurology.

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Families Often Don't Expect Death of Elderly Relative

MONDAY, Nov. 20 (HealthDay News) -- Families often don't recognize that death is near for an elderly relative, and black families are less likely than white families to expect a family member's death. Better communication between physicians and families could improve end-of-life care, researchers report in the November issue of the Journal of the American Geriatrics Society.

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Central Venous O2 Linked to Postop Complications

FRIDAY, Nov. 17 (HealthDay News) -- Low central venous oxygen saturation (ScvO2) during high-risk surgery is linked to postoperative complications, according to a report published Nov. 13 online in the peer-reviewed open access journal Critical Care.

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Primary Care Physicians Miss Signs of Cardiac Ischemia

THURSDAY, Nov. 16 (HealthDay News) -- Primary care clinicians often miss early chances to send patients with cardiac ischemia to the hospital, researchers report in the Nov. 13 issue of the Archives of Internal Medicine. About 11 percent of acute myocardial infarction patients without a previous history of heart disease see their primary care doctor, nurse practitioner or physician's assistant for angina-like pain or other symptoms in the month before hospitalization, but aren't sent to the hospital.

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Correcting Anemia in Kidney Disease May Not Be Beneficial

THURSDAY, Nov. 16 (HealthDay News) -- For patients with chronic kidney disease, fully correcting anemia may increase the risk of adverse events, according to two studies published in the Nov. 16 issue of the New England Journal of Medicine.

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Midlife Self-Care Extends Men's Life Span into 80s, 90s

WEDNESDAY, Nov. 15 (HealthDay News) -- Middle-aged men who avoid common risk factors for chronic disease have a better chance of achieving an "exceptional" survival, defined as living to age 85 and beyond without physical or mental impairment, according to a study published in the Nov. 15 issue of the Journal of the American Medical Association.

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Paclitaxel-Coated Balloon Catheter Reduces Restenosis

TUESDAY, Nov. 14 (HealthDay News) -- In patients with coronary in-stent restenosis, treatment with paclitaxel-coated balloon catheters may significantly reduce the risk of restenosis, according to a study published online Nov. 13 in the New England Journal of Medicine.

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Consensus Achieved on Quality in Cardiovascular Imaging

TUESDAY, Nov. 14 (HealthDay News) -- Guidelines on quality in cardiovascular imaging have now been developed, but their implementation will require a concerted commitment of effort and time, according to a report in the Nov. 14 issue of the Journal of the American College of Cardiology.

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More People Could Benefit from Statins

MONDAY, Nov. 13 (HealthDay News) -- A greater number of people could benefit from statins, and widening the pool of candidates for the drug would be cost-effective, according to the results of a study published online Nov. 10 in BMJ.

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High Cardiac Troponin T Linked to Reduced Survival

FRIDAY, Nov. 10 (HealthDay News) -- Elevated levels of cardiac troponin T following percutaneous coronary intervention is associated with reduced survival in patients with normal creatine kinase levels, according to the results of a study published in the Nov. 7 issue of the Journal of the American College of Cardiology.

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PET Imaging of Carotid Plaques Detects Inflammation

FRIDAY, Nov. 10 (HealthDay News) -- Positron emission tomography (PET) imaging with fluorodeoxyglucose, whose uptake has been shown to be increased in carotid plaques, is an effective and non-invasive way to assess inflammation in patients with severe carotid stenoses, researchers report in the Nov. 7 issue of the Journal of the American College of Cardiology.

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Google Useful to Help Doctors Diagnose Difficult Cases

FRIDAY, Nov. 10 (HealthDay News) -- The increasing availability of Internet access on hospital wards and in outpatient clinics is enabling more and more doctors to access the Web and use the search engine Google to help diagnose difficult cases, according to a study published online Nov. 10 in BMJ.

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Unfractionated Heparin May Cause Higher Risk in Women

FRIDAY, Nov. 10 (HealthDay News) -- Women undergoing surgery who are treated with unfractionated heparin have a high incidence of heparin-induced thrombocytopenia, according to a report in the Nov. 1 issue of Blood. The risk from low-molecular-weight heparin is minimal, regardless of treatment setting.

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High B-Type Natriuretic Peptide Levels Up Women's Death Risk

THURSDAY, Nov. 9 (HealthDay News) -- Elevated B-type natriuretic peptide (BNP) blood levels are associated with a higher mortality risk for women with heart failure than for men, researchers report in the Nov. 7 issue of the Journal of the American College of Cardiology.

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Laser Aids Biventricular Systolic Function in Twin-Twin Syndrome

THURSDAY, Nov. 9 (HealthDay News) -- Selective laser ablation improves the cardiovascular pathology of the recipient twin in twin-twin transfusion syndrome, according to the results of a new study published in the November issue of the American Journal of Obstetrics & Gynecology.

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Low-Carb Diet Does Not Change Heart Disease Risk

WEDNESDAY, Nov. 8 (HealthDay News) -- A low-carbohydrate diet does not influence heart disease risk in women, though risk is moderately reduced when fat and protein come from vegetable rather than animal sources, researchers report in the Nov. 9 issue of the New England Journal of Medicine.

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Half of HF Patients Have Preserved Ejection Fraction

TUESDAY, Nov. 7 (HealthDay News) -- More than half of heart failure patients in the community have preserved ejection fraction and more than 40 percent have isolated diastolic dysfunction, according to a report in the Nov. 8 issue of the Journal of the American Medical Association. What's more, six-month mortality is similar in those with preserved and reduced ejection fraction.

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Systolic Blood Pressure Can Predict Heart Failure Prognosis

TUESDAY, Nov. 7 (HealthDay News) -- Patients admitted to the hospital with heart failure often also have low systolic blood pressure (SBP), which is an independent predictor of mortality and morbidity, researchers report in the Nov. 8 issue of the Journal of the American Medical Association.

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Left Main Coronary Artery Narrowing More Likely in Men

TUESDAY, Nov. 7 (HealthDay News) -- In patients who undergo coronary angiography, men are more likely than women to have left main coronary artery significant stenosis (LMSS) and at a younger age, according to a study in the November issue of the American Journal of Cardiology.

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Study Questions Beta-Blockers for Some with Heart Failure

MONDAY, Nov. 6 (HealthDay News) -- Patients with heart failure and a preserved ejection fraction have reduced vasodilator and cardiac output reserve during exercise, which may not be due entirely to impaired diastolic function, according to a report published online Nov. 6 in Circulation: Journal of the American Heart Association. The findings suggest that beta-blockers may not be the best treatment for patients with "diastolic" heart failure, the authors say.

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Uric Acid Protects Endothelium in Diabetics, Smokers

MONDAY, Nov. 6 (HealthDay News) -- Uric acid can improve endothelial function in type 1 diabetics and regular smokers, possibly through its antioxidant properties, according to a report in the November issue of Diabetes.

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Transmitting EKG May Cut Door-to-Reperfusion Time

MONDAY, Nov. 6 (HealthDay News) -- If emergency technicians transmit electrocardiographic data to a cardiologist's hand-held device before arrival at the hospital, it may result in a shorter door-to-reperfusion time for patients with ST-segment elevation myocardial infarction (STEMI), according to the results of a pilot study published in the November issue of the American Journal of Cardiology.

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Gender Difference Seen in Acute Coronary Syndrome

MONDAY, Nov. 6 (HealthDay News) -- In patients with acute coronary syndrome, men are more likely to present with excessive sweating, or diaphoresis, while women are more likely to present with nausea, according to the results of a study published in the November issue of the American Journal of Cardiology.

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Multiple Organ Failure Causes Most ICU Deaths

FRIDAY, Nov. 3 (HealthDay News) -- Multiple organ failure is responsible for about half of deaths of critically ill patients in the intensive care unit (ICU), while malignant tumor disease and chronic cardiovascular disease were the most frequent causes of death after ICU discharge, according to the results of a study published online Nov. 3 in Critical Care.

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Jehovah's Witnesses Have Same Heart Surgery Outcomes

FRIDAY, Nov. 3 (HealthDay News) -- When blood conservation protocols are used, Jehovah's Witnesses have comparable open cardiac surgery clinical outcomes to those of non-Jehovah's Witnesses, according to research published in the Nov. 1 issue of the American Journal of Cardiology.

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Stop-Smoking Program Effective in Psychotic Patients

THURSDAY, Nov. 2 (HealthDay News) -- A stop-smoking program is effective for smoking cessation and smoking reduction in individuals with a psychotic disorder, according to the results of a study published in the November issue of the American Journal of Psychiatry.

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Diabetics Have Significantly More Coronary Restenosis

THURSDAY, Nov. 2 (HealthDay News) -- Diabetics have significantly higher coronary restenosis rates than non-diabetics due to inferior procedural outcomes and increased neointimal cell proliferation, according to a report in the November issue of the American Journal of Cardiology.

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Left Ventricular Assist Device Can Reverse Heart Failure

THURSDAY, Nov. 2 (HealthDay News) -- Many patients with severe heart failure secondary to non-ischemic cardiomyopathy could be treated effectively and see regression of their disease with the use of a left ventricular assist device, according to a report in the Nov. 2 New England Journal of Medicine.

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Commercial HMOs Embrace Pay-for-Performance Programs

WEDNESDAY, Nov. 1 (HealthDay News) -- Pay-for-performance programs are now used by a majority of commercial health maintenance organizations, according to a special report published in the Nov. 2 issue of the New England Journal of Medicine.

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Resveratrol Improves Health, Survival of Obese Mice

WEDNESDAY, Nov. 1 (HealthDay News) -- Resveratrol, a compound found in wine, fruit and nuts, significantly improves the health and survival of obese middle-aged mice fed a high-calorie diet, according to the results of a study published online Nov. 1 in Nature.

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Test Good Predictor of Survival in Pulmonary Hypertension

WEDNESDAY, Nov. 1 (HealthDay News) -- Tricuspid annular plane systolic excursion (TAPSE), a non-invasive echo-derived test, is a powerful measure of right heart function that predicts survival in patients with pulmonary arterial hypertension, according to an article in the November issue of the American Journal of Respiratory and Critical Care Medicine.

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