October 2010 Briefing - Cardiology

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

Sodium Intake in U.S. Adults Not Seen to Fall Over Time

FRIDAY, Oct. 29 (HealthDay News) -- Based on data dating back to the 1950s, sodium intake among adults in the United States appears to exceed recommended intakes, with no evident decrease over time, according to research published in the November issue of the American Journal of Clinical Nutrition.

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Ancillary Aortic Findings May Predict CVD

THURSDAY, Oct. 28 (HealthDay News) -- A prediction model that uses computed tomography (CT) findings of ancillary aortic abnormalities may help physicians identify individuals at high risk for cardiovascular disease (CVD), according to research published in the November issue of Radiology.

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For Coronary Patients, H2RA Plus Clopidogrel Spikes Risk

THURSDAY, Oct. 28 (HealthDay News) -- The concomitant use of a histamine2-receptor antagonist (H2RA) and clopidogrel for patients with prior acute coronary syndrome (ACS) more than doubles the risk of rehospitalization or death compared to treatment with clopidogrel only, according to research published in the October issue of Gastroenterology.

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Red Yeast Rice Supplements Lacking Standardization

WEDNESDAY, Oct. 27 (HealthDay News) -- Red yeast rice, a popular dietary supplement for reducing cholesterol, contains widely differing concentrations of monacolins, the active ingredients, by brand, and some contain a potentially toxic substance, according to research published in the Oct. 25 issue of the Archives of Internal Medicine.

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Genetic Variants Spike Cardio Risk for Patients on Clopidogrel

TUESDAY, Oct. 26 (HealthDay News) -- Individuals treated with clopidogrel for percutaneous coronary intervention who are carriers of reduced-function CYP2C19 alleles are more likely to suffer major cardiovascular events than patients without the genetic variants, according to research published in the Oct. 27 issue of the Journal of the American Medical Association.

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Primary Care Trails Other Specialties in Hourly Wages

TUESDAY, Oct. 26 (HealthDay News) -- Primary care physicians have substantially lower hourly wages than other specialists, and although most physicians find Medicare reimbursement inequitable, they show little consensus on how to reform it, according to two studies published in the Oct. 25 issue of the Archives of Internal Medicine.

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Barbershop Program Linked to Blood Pressure Benefits

TUESDAY, Oct. 26 (HealthDay News) -- A program in which barbers with predominantly African-American clients conduct blood pressure monitoring and referral may improve hypertension control among black men, according to research published online Oct. 25 in the Archives of Internal Medicine.

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Gene Regulation May Prevent Cardiac Hypertrophy

FRIDAY, Oct. 22 (HealthDay News) -- Regulating expression of the phosphodiesterase type 5 (PDE5) gene in heart muscle cells can reverse maladaptive heart remodeling, such as cardiac hypertrophy, caused by sustained pressure overloads, according to the results of a mouse study published online Oct. 20 in the Journal of the American College of Cardiology.

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ApoA-V Decreases Triglyceride Levels in Mouse Model

FRIDAY, Oct. 22 (HealthDay News) -- A minor lipoprotein-associated protein currently being studied in mice, and designated Apolipoprotein A-V (apoA-V), shows potential as a future treatment for humans with severe hypertriglyceridemia (HTG), according to research published online Oct. 21 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Genetic Risk Score Identifies Heart Disease-Vulnerable

FRIDAY, Oct. 22 (HealthDay News) -- A genetic risk score based on 13 newly identified single nucleotide polymorphisms (SNPs) appears to be associated with the risk of a coronary heart disease event, and slightly improves risk reclassification of participants whose traditional risk factors identify them as being at intermediate risk, according to research published in the Oct. 23 issue of The Lancet.

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Low Testosterone Linked With CVD-Related Mortality

FRIDAY, Oct. 22 (HealthDay News) -- New research suggests a link between low testosterone levels and increased risk of death in men who have heart disease, according to a report published online Oct. 19 in Heart.

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New Guidelines for Recurrent Stroke Prevention Published

FRIDAY, Oct. 22 (HealthDay News) -- A joint committee representing the American Heart Association and the American Stroke Association has published updated evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack; the statement has been published online Oct. 21 in Stroke.

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Ankle-Brachial Index Linked to Risk of Cardiovascular Disease

THURSDAY, Oct. 21 (HealthDay News) -- Having a low or high ankle-brachial index (ABI) is associated with an increased risk of cardiovascular disease (CVD), according to research published in the Oct. 26 issue of the Journal of the American College of Cardiology.

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FDA to Update Prescribing Labels of GnRH Agonists

THURSDAY, Oct. 21 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals and consumers that the prescribing labels of gonadotropin-releasing hormone (GnRH) agonists will be updated with new safety information.

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Weekly INR Self-Testing Not Superior to Monthly Clinic Tests

WEDNESDAY, Oct. 20 (HealthDay News) -- In patients using warfarin, self-testing of international normalized ratio (INR) doesn't appear superior to clinic testing for reducing the risk of adverse outcomes, including major bleeding and stroke, according to research published in the Oct. 21 issue of the New England Journal of Medicine.

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Same-Day Discharge After PCI Cuts Medical Costs in Half

WEDNESDAY, Oct. 20 (HealthDay News) -- Same-day discharge of patients after uncomplicated percutaneous coronary intervention (PCI) cuts the overall medical cost of the procedure by more than half, according to a study in the October issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

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Pradaxa Approved for Atrial Fibrillation

WEDNESDAY, Oct. 20 (HealthDay News) -- Pradaxa (dabigatran etexilate) has been approved by the U.S. Food and Drug Administration to help prevent stroke in people with a type of abnormal heart rhythm called atrial fibrillation.

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Corticosteroids Decrease Recurrent A-Fib After Ablation

WEDNESDAY, Oct. 20 (HealthDay News) -- The short-term use of corticosteroids following atrial fibrillation (AF) ablation may safely prevent AF recurrences both immediately after pulmonary vein isolation and over longer follow-up, according to research published in the Oct. 26 issue of the Journal of the American College of Cardiology.

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Cardiorespiratory Fitness Linked to Cardiac Death Risk

WEDNESDAY, Oct. 20 (HealthDay News) -- Although better cardiorespiratory fitness reduces the risk of sudden cardiac death (SCD) in middle-aged and older men, adding this risk factor to a conventional risk-prediction model only modestly improves SCD prediction, according to research published in the Oct. 26 issue of the Journal of the American College of Cardiology.

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Invasive Dental Procedures May Up Vascular Event Risk

TUESDAY, Oct. 19 (HealthDay News) -- Whether due to inflammatory effects or to a brief cessation of daily aspirin or other antiplatelet therapy, invasive dental treatments appear to be associated with a transient increased risk of a vascular event, particularly in the first four weeks after surgery, according to research published in the Oct. 19 issue of the Annals of Internal Medicine.

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New CPR Guidelines Emphasize Chest Compression First

TUESDAY, Oct. 19 (HealthDay News) -- Lay and professional rescuers using cardiopulmonary resuscitation (CPR) to revive someone stricken by cardiac arrest should begin chest compressions first to quickly restore blood circulation, rather than risk the delay to clear the patient's airway and restart breathing, according to the "2010 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care," published online Oct. 18 in Circulation.

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Hypertensive Black Children at Higher Risk Than Non-Blacks

MONDAY, Oct. 18 (HealthDay News) -- African-American children with primary hypertension have clinical characteristics that place them at higher risk of developing heart disease than non-African-American children, according to research published online Oct. 18 in Pediatrics.

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Coronary Artery Calcium Aids Risk Classification in Elderly

FRIDAY, Oct. 15 (HealthDay News) -- Coronary artery calcium (CAC) levels can be used to fine-tune coronary heart disease (CHD) risk assessment in elderly people with no disease symptoms, according to a study in the Oct. 19 issue of the Journal of the American College of Cardiology.

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Chest-Compression-Only CPR Should Be Recommended

FRIDAY, Oct. 15 (HealthDay News) -- Chest-compression-only cardiopulmonary resuscitation (CPR) should be recommended by emergency medical services to bystanders caring for individuals experiencing out-of-hospital cardiac arrest rather than standard CPR with mouth-to-mouth, according to research published online Oct. 15 in The Lancet.

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Stent and CABG Patients Have Similar Mortality Risk

THURSDAY, Oct. 14 (HealthDay News) -- Patients with unprotected left main coronary artery (LMCA) disease who undergo percutaneous coronary intervention (PCI) with stent implantation have similar long-term mortality risk, but a substantially higher revascularization risk, than those who undergo coronary artery bypass grafting (CABG), according to a study published in the Oct. 19 issue of the Journal of the American College of Cardiology.

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Percutaneous Ventricular Assist Device Effective

THURSDAY, Oct. 14 (HealthDay News) -- Implantation of a percutaneous ventricular assist device (pVAD) can rapidly improve hemodynamic parameters in patients with severe refractory cardiogenic shock (SRCS) despite intra-aortic balloon pump (IABP) and vasopressor support, according to research published online Oct. 13 in the Journal of the American College of Cardiology.

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ANGPTL3 Mutations Tied to Lipid Disorder

THURSDAY, Oct. 14 (HealthDay News) -- ANGPTL3 mutations appear to be associated with extremely low plasma low-density lipoprotein (LDL) cholesterol levels among individuals with familial combined hypolipidemia, which may represent a new target for the lowering of LDL cholesterol levels, according to a brief report published online Oct. 13 in The New England Journal of Medicine.

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Bisphosphonates Up Risk of A-Fib in Cancer Patients

WEDNESDAY, Oct. 13 (HealthDay News) -- Older cancer patients who receive intravenous bisphosphonate therapy may be at a modestly increased risk for atrial fibrillation, supraventricular tachycardia (SVT), and stroke, according to research published online Oct. 12 in the Journal of Clinical Oncology.

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Prior Aspirin Use Is Marker for Recurrent MI Risk After ACS

WEDNESDAY, Oct. 13 (HealthDay News) -- Patients with a history of aspirin use who experience an incident of acute coronary syndrome (ACS) are at modestly higher risk of recurrent myocardial infarction (MI), but not mortality, compared with non-prior aspirin users, according to a study in the Oct. 19 issue of the Journal of the American College of Cardiology.

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Transfusion Policies for Cardiac Surgery Vary in U.S.

TUESDAY, Oct. 12 (HealthDay News) -- Transfusion practices vary widely among institutions providing cardiac surgery, but a restrictive perioperative transfusion status does not appear to be inferior to a more liberal transfusion strategy in terms of 30-day morbidity and mortality, according to two studies published in the Oct. 13 issue of The Journal of the American Medical Association.

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Peripheral Artery Disease Procedures Recurrent, Costly

WEDNESDAY, Oct. 13 (HealthDay News) -- Peripheral artery disease (PAD) carries a high economic burden, with many asymptomatic patients going on to experience an ischemic event requiring hospitalization and many symptomatic patients requiring one or more revascularizations and other procedures, according to research published online Oct. 12 in Circulation: Cardiovascular Quality and Outcomes.

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Nightly Blood Pressure Dosing Improves Outcomes

TUESDAY, Oct. 12 (HealthDay News) -- Administration of at least one blood pressure (BP) medication at night instead of upon waking appears to significantly improve BP control, decrease the prevalence of non-dipping, and reduce cardiovascular disease (CVD) morbidity and mortality, according to a study published in the September issue of Chronobiology International.

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M.D.-Pharmacist Collaboration Helps Hypertensive Patients

TUESDAY, Oct. 12 (HealthDay News) -- A collaborative effort of physicians and pharmacists appears to result in improved blood pressure (BP) control in hypertensive patients, and continued education in cessation counseling may help physicians, but perhaps not pharmacists, do a better job at helping patients quit smoking, according to two articles published Oct. 11 in the Archives of Internal Medicine.

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B-Vitamin Therapy May Not Be Useful

MONDAY, Oct. 11 (HealthDay News) -- Routine supplementation with folic acid for five years has no effect on cardiovascular outcomes, cancer incidence, or mortality, according to a meta-analysis published Oct. 11 in the Archives of Internal Medicine.

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Anti-PE Benefit Seen From Inferior Vena Cava Filters

FRIDAY, Oct. 8 (HealthDay News) -- The prophylactic use of inferior vena cava filters (IVCFs) appears safe and effective in preventing pulmonary embolism (PE) in patients undergoing major spinal surgery who are at high risk, according to research published in the Sept. 15 issue of Spine.

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Workplace Noise Exposure Linked to Heart Conditions

FRIDAY, Oct. 8 (HealthDay News) -- Chronic exposure to workplace noise is associated with substantially increased risk for angina pectoris, myocardial infarction (MI), coronary heart disease (CHD), and isolated diastolic hypertension, according to research published online Oct. 5 in Occupational and Environmental Medicine.

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Faith-Based Intervention Facilitates Lifestyle Change

FRIDAY, Oct. 8 (HealthDay News) -- Sisters in Motion, a faith-based intervention designed to increase walking and lower blood pressure in older, sedentary African-American women appears to be effective, according to research published in the October issue of the Journal of the American Geriatrics Society.

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Stress Testing Common in Years After Revascularization

FRIDAY, Oct. 8 (HealthDay News) -- The majority of patients undergoing coronary revascularization are likely to have a stress test in the following two years, with relatively few requiring repeat revascularization, according to research published in the Oct. 12 issue of the Journal of the American College of Cardiology.

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Well-Being, Cardiorespiratory Fitness Key to Survival

THURSDAY, Oct. 7 (HealthDay News) -- Low levels of negative emotion and high levels of cardiorespiratory fitness (CRF) are independent predictors of long-term survival, and individuals who have both are at much lower risk of premature death, according to research published in the October issue of the American Journal of Preventive Medicine.

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Omeprazole Shows Benefit With Aspirin, Clopidogrel

WEDNESDAY, Oct. 6 (HealthDay News) -- Omeprazole may be associated with a lower risk of upper gastrointestinal bleeding in patients taking aspirin and clopidogrel, without a significant increase in risk of cardiovascular events, according to research published online Oct. 6 in the New England Journal of Medicine.

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Rolofylline Not Found to Help Acute Heart Failure Patients

WEDNESDAY, Oct. 6 (HealthDay News) -- The adenosine A1-receptor antagonist rolofylline does not appear beneficial in treating acute heart failure patients with renal dysfunction, according to research published in the Oct. 7 issue of the New England Journal of Medicine.

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Hypoglycemia Associated With Variety of Adverse Outcomes

WEDNESDAY, Oct. 6 (HealthDay News) -- Severe hypoglycemia is associated with a higher risk of a number of adverse clinical outcomes in type 2 diabetes patients, but the relationship may not be causal, according to research published in the Oct. 7 issue of the New England Journal of Medicine.

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Coronary Artery Disease Genetic Variants Identified

WEDNESDAY, Oct. 6 (HealthDay News) -- A meta-analysis of currently available genome-wide association studies (GWAS) has confirmed the identification of genetic variants associated with myocardial infarction (MI) and other forms of coronary artery disease (CAD) in a proof-of-principle study published online Oct. 5 in Circulation: Cardiovascular Genetics.

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Increasing Catheter Size Tied to Greater Thrombosis Risk

WEDNESDAY, Oct. 6 (HealthDay News) -- Previous deep vein thrombosis (DVT) and increasing catheter size are related to an increased risk for peripherally inserted central catheter (PICC)-associated DVT, according to a study in the October issue of Chest.

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For Bystander Resuscitation, Compression-Only CPR Better

TUESDAY, Oct. 5 (HealthDay News) -- Compression-only cardiopulmonary resuscitation (COCPR) administered by laypersons in out-of-hospital cardiac arrest situations is associated with higher survival rates than conventional CPR, according to research published in the Oct. 6 issue of the Journal of the American Medical Association.

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Testosterone May Lend Benefit in Women With CHF

TUESDAY, Oct. 5 (HealthDay News) -- In women with advanced chronic heart failure, testosterone supplementation is associated with improved functional capacity, insulin resistance, and muscle strength, according to research published in the Oct. 12 issue of the Journal of the American College of Cardiology.

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Successful Fat Loss May Require Adequate Sleep

TUESDAY, Oct. 5 (HealthDay News) -- Overweight dieters who don't get enough sleep may lose less fat and more fat-free body mass while experiencing greater hunger than those who get adequate nightly rest, according to research published in the Oct. 5 issue of the Annals of Internal Medicine.

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AHA Issues Arterial Closure Device Recommendations

TUESDAY, Oct. 5 (HealthDay News) -- The number and quality of clinical studies on arterial closure devices (ACDs) for cardiovascular procedures limits their widespread use, but new recommendations issued by the American Heart Association are intended to aid cardiologists considering use of these technologies. The recommendations were published online Oct. 4 in Circulation.

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Study Validates Noninvasive Blood Test for CAD

TUESDAY, Oct. 5 (HealthDay News) -- A new blood test measuring gene expression can modestly increase the accuracy of predicting obstructive coronary artery disease (CAD) in patients without diabetes or known CAD, according to research published in the Oct. 5 issue of the Annals of Internal Medicine.

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Consensus Statement Pushes Lower BP Goals in Blacks

TUESDAY, Oct. 5 (HealthDay News) -- The updated International Society on Hypertension in Blacks (ISHIB) consensus statement on the management of hypertension in this population places a major emphasis on comprehensive assessment and appropriate risk stratification of individual patients with hypertension, according to a report published online Oct. 4 in Hypertension.

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Doctors' Exercise Linked to Confidence Counseling Patients

FRIDAY, Oct. 1 (HealthDay News) -- Physicians' exercise habits and weight are associated with their confidence in their abilities to counsel patients on exercise and diet, as is the level of training they have received in counseling techniques, according to research published in the fall issue of Preventive Cardiology.

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Early Pregnancy Sleep Duration Tied to Hypertension Risks

FRIDAY, Oct. 1 (HealthDay News) -- Both short and long sleep durations during early pregnancy are associated with elevated blood pressure (BP) as well as increased risks of pregnancy-induced hypertension and preeclampsia during the third trimester, according to research published in the Oct. 1 issue of SLEEP.

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Impaired Kidney Function Linked to Future Stroke Risk

FRIDAY, Oct. 1 (HealthDay News) -- A low estimated glomerular filtration rate (eGFR) is associated with later risk of stroke, and even early stages of chronic kidney disease are associated with a higher risk of subsequent coronary heart disease, according to research published Sept. 30 in BMJ.

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Modest Drinking Tied to Lower Cardiac Death Risk in Women

FRIDAY, Oct. 1 (HealthDay News) -- Lower levels of alcohol intake are associated with a significantly reduced risk of sudden cardiac death (SCD) among women, according to research published in the October issue of Heart Rhythm.

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