September 2007 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for September 2007. 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.

Sleep Apnea Treatment Improves Atherosclerosis

FRIDAY, Sept. 28 (HealthDay News) -- Treatment of obstructive sleep apnea with continuous positive airway pressure (CPAP) improves early markers of atherosclerosis, suggesting that sleep apnea contributes to the development of atherosclerosis, according to research published in the American Journal of Respiratory & Critical Care Medicine in October.

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Guidelines Proposed for Medical Emergency Research

THURSDAY, Sept. 27 (HealthDay News) -- A risk-based stratified template would help institutional review boards in the approval process for research conducted in emergency situations where it is difficult or impossible to obtain patient consent, according to recommendations published online Sept. 24 in Circulation: Journal of the American Heart Association.

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Post-Heart Attack Cardiac Rehabilitation Underused

THURSDAY, Sept. 27 (HealthDay News) -- Older patients are missing out on cardiac rehabilitation, despite the fact that it has been proven to prolong survival and reduce disability, according to a report published online Sept. 24 in Circulation: Journal of the American Heart Association.

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Hypertension, Overweight Are Harbingers of Heart Failure

THURSDAY, Sept. 27 (HealthDay News) -- There is a positive association between higher blood pressure and body mass index in midlife and an increased risk of heart failure during later life, according to the results of a study published online Sept. 24 in Hypertension.

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HDL Predicts Risk of Major Cardiovascular Events

WEDNESDAY, Sept. 26 (HealthDay News) -- Levels of high-density lipoprotein (HDL) cholesterol predict the risk of major cardiovascular events even in patients whose low-density lipoprotein (LDL) cholesterol has been substantially lowered by statins, according to study findings published in the Sept. 27 issue of the New England Journal of Medicine.

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One Thrombosis Develops for Every 4,500 Long Flights

WEDNESDAY, Sept. 26 (HealthDay News) -- Flights lasting more than four hours moderately increase the likelihood of venous thromboembolism, with a risk of roughly one event for every 4,500 flights, according to a report published in the September issue of PLOS Medicine.

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Norepinephrine May Improve Survival in Hemorrhagic Shock

WEDNESDAY, Sept. 26 (HealthDay News) -- In the treatment of trauma victims with uncontrolled bleeding and shock, early-phase fluid resuscitation plus norepinephrine may offer a new strategy for improving the odds of survival, according to the results of an animal study published in the October issue of Anesthesiology.

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Coronary Disease Linked to Colorectal Neoplasms

TUESDAY, Sept. 25 (HealthDay News) -- Patients with coronary artery disease are also at greater risk for colorectal neoplasms, according to a report in the Sept. 26 issue of the Journal of the American Medical Association.

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Prehypertension Can Worsen with Anger and Stress

TUESDAY, Sept. 25 (HealthDay News) -- Prehypertensive individuals who have problems with anger or stress in middle-age are at greater risk of progressing to full-blown hypertension or heart disease as they age, according to a report in the September/October issue of the Annals of Family Medicine.

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Hispanic Ethnicity No Barrier to Hypertension Control

TUESDAY, Sept. 25 (HealthDay News) -- Despite the fact that blood pressure control among Hispanic populations has been suboptimal, once cost and access barriers are overcome there are no racial disparities in prevention of hypertension, according to a report published online Sept. 10 in Hypertension.

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Familiar Doctor Linked to More Satisfaction for Urgent Care

TUESDAY, Sept. 25 (HealthDay News) -- Patients who receive urgent medical care from family physicians or after-hours clinics affiliated with their physicians are more likely to be satisfied with the encounter than patients who use other sources of urgent care, according to research published in the September/October issue of the Annals of Family Medicine.

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Hospitalist Care Linked to Shorter Hospital Stays

MONDAY, Sept. 24 (HealthDay News) -- Hospitalized patients who are under the care of a hospital-based general physician -- or hospitalist -- may have shorter stays than those under conventional hospital care, according to the results of a study in the Sept. 24 issue of the Archives of Internal Medicine.

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Region of Brain Found to Play Role in Sensory Perception

MONDAY, Sept. 24 (HealthDay News) -- The ventrolateral nucleus of the thalamus (VL) in the brain is believed to be involved in motor functions, but new research suggests it is also involved in sensory processing, and damage to the area results in neural reorganization that impacts sensory perception, according to a report published online Sept. 24 in the Annals of Neurology.

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Many Women Unfamiliar with 'Women's Health' Findings

MONDAY, Sept. 24 (HealthDay News) -- Despite the widespread publicity of the Women's Health Initiative (WHI) clinical trial published in 2002 -- which found that the risk-benefit ratio of estrogen plus progestin made it an unwise choice for preventing disease -- only a minority of women were aware of these results two years later, researchers report in the September/October issue of Menopause.

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Risk of Stroke May Be Due to Childhood Residence

MONDAY, Sept. 24 (HealthDay News) -- People who grew up in the group of seven southern states known as the "Stroke Belt" or who live there as adults are at greater risk of stroke than people elsewhere in the United States, according to a report in the September issue of Stroke.

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Liver-Activated Drug Lowers Cholesterol and Triglycerides

FRIDAY, Sept. 21 (HealthDay News) -- A drug that targets the thyroid hormone receptor but is only activated in the liver lowers both cholesterol and triglycerides in rodents without the undesirable systemic side effects, according to a study published online Sept. 18 in the Proceedings of the National Academy of Sciences.

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Minimally Invasive Valve Surgery Beneficial to Patients

FRIDAY, Sept. 21 (HealthDay News) -- In patients who have undergone previous cardiac surgery, minimally invasive, video-assisted keyhole valve surgery is associated with high patient satisfaction and lower mortality than open-chest valve surgery, according to study findings published in a cardiovascular surgery supplement to the Sept. 4 issue of Circulation: Journal of the American Heart Association.

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Proton Pump Inhibitors Useful in Iron Overload Diseases

FRIDAY, Sept. 21 (HealthDay News) -- In patients with hereditary hemochromatosis, treatment with proton pump inhibitors reduces phlebotomy requirements and absorption of non-heme iron from meals, suggesting that such therapy could complement phlebotomy in the management of iron-overload diseases, according to a report published in the September issue of Gut.

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Diabetes Drug Sulfonylurea Shows Benefit for Stroke

FRIDAY, Sept. 21 (HealthDay News) -- Type 2 diabetes patients may be more likely to have successful recoveries from strokes if they are taking sulfonylurea drugs, researchers report in the September issue of Stroke.

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Progress Made in Tissue-Engineered Heart Valves

THURSDAY, Sept. 20 (HealthDay News) -- Pre-coating a biodegradeable scaffold with extracellular matrix proteins can help guide the type of tissue formed when engineering heart valves, according to the results of an animal study published online Sept. 10 in Circulation: Journal of the American Heart Association.

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FDA Clears Genetic Test for Warfarin Sensitivity

THURSDAY, Sept. 20 (HealthDay News) -- The U.S. Food and Drug Administration has cleared a new genetic test for determining a patient's sensitivity to warfarin (Coumadin). The Nanosphere Verigene Warfarin Metabolism Nucleic Acid Test detects variants of two genes, CYP2C9 and VKORC1, which have been shown to account for some of the variation in response to the drug.

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Gene Variation Linked to Greater Risk of Scleroderma

THURSDAY, Sept. 20 (HealthDay News) -- The G-945C polymorphism in the connective-tissue growth factor gene is strongly associated with systemic sclerosis, making it a candidate gene for scleroderma, according to study findings published in the Sept. 20 issue of the New England Journal of Medicine.

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Left Atrial Size Indicator of Diastolic Function, Cardiac Risk

THURSDAY, Sept. 20 (HealthDay News) -- Left atrial size, a surrogate marker of diastolic function, is an independent risk factor for myocardial infarction and cardiac death, according to the results of a study published in the Sept. 25 issue of the Journal of the American College of Cardiology. Left atrial size can be measured during stress echocardiography and used as a "powerful" prognostic indicator, the authors write.

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Device Reduces Atrial Arrhythmia After Heart Failure

WEDNESDAY, Sept. 19 (HealthDay News) -- Patients with heart failure and left ventricular dysfunction who are upgraded to a cardiac resynchronization therapy-defibrillator have reduced atrial tachyarrhythmia, according to study findings published in the Sept. 25 issue of the Journal of the American College of Cardiology.

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Medical Schools Vary in Approach to Case Reports

WEDNESDAY, Sept. 19 (HealthDay News) -- Most medical school institutional review boards (IRBs) don't treat individual case reports as "research," as it's defined by the United States Government Code of Federal Regulations, according to a research letter published in the Sept. 19 issue of the Journal of the American Medical Association.

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Hypertension Common in Rheumatoid Arthritis Patients

WEDNESDAY, Sept. 19 (HealthDay News) -- Patients with rheumatoid arthritis have an especially high prevalence of hypertension, which is often underdiagnosed in younger patients and undertreated in older patients with cardiovascular disease, according to a report in the September issue of Rheumatology.

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Apolipoprotein E2 Linked to Favorable Cardiac Profile

TUESDAY, Sept. 18 (HealthDay News) -- Apolipoprotein E (apoE) genotypes correlate linearly with low-density lipoprotein cholesterol (LDL-C) levels and coronary risk, and the e2 genotype is associated with the lowest cardiovascular risk, according to the results of a large meta-analysis in the Sept. 19 issue of the Journal of the American Medical Association.

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Survival on Heart Transplant List Improved Since 1990

TUESDAY, Sept. 18 (HealthDay News) -- The survival of patients listed for heart transplantation has significantly improved since 1990, with the greatest benefit for those at greatest risk of death, according to a study published in the Sept. 25 issue of the Journal of the American College of Cardiology.

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Pulmonary Hypertension Worsens in Placebo Groups

TUESDAY, Sept. 18 (HealthDay News) -- Patients with pulmonary arterial hypertension who receive a placebo during a clinical trial instead of an active treatment are almost twice as likely to have their condition worsen, according to a meta-analysis in the September issue of Chest. The findings suggest that clinical trials should compare treatment groups, rather than use a placebo.

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Sleep Apnea Treatment Lowers Cardiovascular Biomarkers

TUESDAY, Sept. 18 (HealthDay News) -- Patients with obstructive sleep apnea-hypopnea syndrome who adhere to their continuous positive airway pressure (CPAP) treatment have a decrease in their cholesterol level, C-reactive protein and other biomarkers of cardiovascular risk, researchers report in the September issue of Chest.

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Congenital Heart Defect Boosts Mortality Risk Later On

TUESDAY, Sept. 18 (HealthDay News) -- Children who undergo surgery for congenital heart defect have a higher risk of death due to cardiac and non-cardiac causes later in life than their peers who have not had a congenital heart defect, according to study findings published online Sept. 9 in the Journal of the American College of Cardiology.

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In U.S., Only One in Four Aware of Peripheral Arterial Disease

MONDAY, Sept. 17 (HealthDay News) -- The risks associated with peripheral arterial disease are poorly understood by the general public, and only one in four people over age 50 report that they've heard of the condition, according to a survey in the Sept. 18 issue of Circulation: Journal of the American Heart Association.

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Asthma Medication May Reduce Cardiovascular Risk

MONDAY, Sept. 17 (HealthDay News) -- Patients with asthma taking montelukast and low-dose theophylline have lower serum levels of inflammatory biomarkers and lipids than those who do not, suggesting that these medications may lower their risk of cardiovascular disease, according to a report published in the September issue of Chest.

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Heart-Patient Discharge Protocol Adherence Faulted

MONDAY, Sept. 17 (HealthDay News) -- Improved adherence to the American Heart Association's Get With the Guidelines discharge protocols could help prevent secondary cardiovascular events in patients who are hospitalized for heart disease, especially those who undergo coronary artery bypass graft surgery, according to a study published in a supplement to the Sept. 4 issue of Circulation: Journal of the American Heart Association.

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NSAID Users Benefit from Proton Pump Inhibitors

MONDAY, Sept. 17 (HealthDay News) -- Patients taking non-steroidal anti-inflammatory drugs (NSAIDs) may have a lower risk of gastropathy when they are co-prescribed a proton pump inhibitor, according to study findings published in the September issue of Gastroenterology.

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Off-Pump Bypass Surgery Improves Women's Survival

FRIDAY, Sept. 14 (HealthDay News) -- Women who undergo off-pump coronary artery bypass graft surgery are less likely to die or suffer strokes or heart attacks than women who undergo conventional on-pump surgery, and more likely to achieve outcomes comparable to those of male bypass patients, according to study findings published online Sept. 11 in a cardiovascular surgery supplement to Circulation: Journal of the American Heart Association.

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Cholesterol Screening Should Be Done in Childhood

FRIDAY, Sept. 14 (HealthDay News) -- Cholesterol screening is most effective when done in childhood, and experts recommend that children be screened at age 15 months at the time of childhood immunizations, according to a report published online Sept. 13 in BMJ.

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Myocardial Infarction Risk Lower with Sirolimus Stent

FRIDAY, Sept. 14 (HealthDay News) -- Sirolimus-eluting stents are associated with lower rates of myocardial infarction than paclitaxel-eluting and bare-metal stents, though the overall risk of mortality does not differ among the stent types, according to a meta-analysis in the Sept. 15 issue of The Lancet.

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Idraparinux Not Superior for Venous Thromboembolism

WEDNESDAY, Sept. 12 (HealthDay News) -- In patients with venous thromboembolism, initial and extended treatment with idraparinux yields only marginal benefits compared to standard treatment, according to two reports published in the Sept. 13 issue of the New England Journal of Medicine.

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Diesel Exhaust Has Ischemic and Thrombotic Effects

WEDNESDAY, Sept. 12 (HealthDay News) -- In men with stable heart disease, even limited exposure to diesel exhaust fosters myocardial ischemia and inhibits endogenous fibrinolytic capacity, according to a report in the Sept. 13 issue of the New England Journal of Medicine.

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Seniors Stop Taking Medication If Insurance Caps Benefits

WEDNESDAY, Sept. 12 (HealthDay News) -- Elderly patients whose health insurance caps drug benefits are more likely to stop taking their medication for diabetes and other chronic ailments than those with plans that do not cap drug benefits, researchers report in the September/October issue of Health Affairs.

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Higher Serum Calcium Linked to Smaller Infarct Volumes

WEDNESDAY, Sept. 12 (HealthDay News) -- In patients with acute ischemic stroke, those with the highest serum calcium levels had the smallest infarct volume, according to a report published in the September issue of the Archives of Neurology.

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B Vitamins Fail to Reduce Deaths in Kidney Patients

TUESDAY, Sept. 11 (HealthDay News) -- Among patients with chronic kidney disease and end-stage renal disease, treatment with folic acid and B vitamins did not reduce their mortality or lower their incidence of cardiovascular events, according to the results of a study published in the Sept. 12 issue of the Journal of the American Medical Association.

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Glycemic Control Drugs Linked with Heart Failure in Diabetics

TUESDAY, Sept. 11 (HealthDay News) -- Two blood glucose-lowering thiazolidinediones -- pioglitazone (Actos) and rosiglitazone (Avandia) -- can increase heart failure risk in diabetes patients, but the net cardiovascular effect of pioglitazone may be favorable because it is linked to a lower risk of myocardial infarction and stroke, according to a pair of meta-analyses in the Sept. 12 issue of the Journal of the American Medical Association.

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Strategies Needed to Treat Comorbid Chronic Diseases

TUESDAY, Sept. 11 (HealthDay News) -- Rather than treat a specific disease in older adults, clinicians may better improve overall health by identifying associated conditions and developing appropriate intervention strategies, according to a research letter published in the Sept. 12 issue of the Journal of the American Medical Association.

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Carvedilol Not Linked to Better Heart Outcomes in Youths

TUESDAY, Sept. 11 (HealthDay News) -- In what one editorialist called a disappointing finding, carvedilol does not offer significant improvement in clinical heart failure outcomes for children and adolescents with systolic heart failure, according to study findings published in the Sept. 12 issue of the Journal of the American Medical Association.

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Gene Variants Associated with Smoking Response

TUESDAY, Sept. 11 (HealthDay News) -- Certain variants of the nicotinic acetylcholine receptor gene are associated with a greater sensitivity to smoking, including heart pounding, dizziness and experiencing a "rush" or "high," according to a report in the September issue of the Archives of General Psychiatry. In addition, patients with such variants may respond better to faster-acting types of smoking cessation treatments, such as nicotine sprays.

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Supplement Recalled Due to Undeclared Sildenafil

TUESDAY, Sept. 11 (HealthDay News) -- The U.S. Food and Drug Administration has announced the recall of a dietary supplement known as Zencore Tabs due to the presence of analogs of the erectile dysfunction drugs tadalafil and sildenafil. These undeclared ingredients may interact with nitrates found in prescription drugs, such as nitroglycerin.

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BP, Cholesterol Big Players in Heart Disease in Overweight

MONDAY, Sept. 10 (HealthDay News) -- Blood pressure and cholesterol levels account for about half the increased risk of coronary heart disease due to overweight, according to study findings published in the Sept. 10 issue of the Archives of Internal Medicine.

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Children's Blood Pressure on the Rise in United States

MONDAY, Sept. 10 (HealthDay News) -- The incidence of high blood pressure and pre-high blood pressure among U.S. children and adolescents is on the rise, which may result in an increased risk of early organ damage and cardiovascular disease, according to study findings published online Sept. 10 in Circulation: Journal of the American Heart Association.

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Weight Gain Predicts Heart Failure Hospitalization

MONDAY, Sept. 10 (HealthDay News) -- Weight gains of as little as two pounds are associated with a greater risk of hospitalization in patients with heart failure, according to a study published online Sept. 10 in Circulation: Journal of the American Heart Association.

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Vitamin E May Protect Women Against Blood Clots

MONDAY, Sept. 10 (HealthDay News) -- Vitamin E may protect women from the risk of venous thromboembolism, particularly those with a history of emboli or a genetic susceptibility, according to study findings published online Sept. 10 in Circulation: Journal of the American Heart Association.

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Depression Hinders Heart Rate Recovery in Coronary Patients

FRIDAY, Sept. 7 (HealthDay News) -- The heart rate variability of depressed acute coronary syndrome patients decreases when their depression fails to improve, according to the results of a study published in the September issue of the Archives of General Psychiatry.

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Depression Exacts Higher Toll Than Chronic Conditions

FRIDAY, Sept. 7 (HealthDay News) -- Depression, especially when accompanied by other chronic physical health conditions, has a greater effect on reducing mean health scores than conditions such as angina, arthritis, asthma and diabetes alone, according to study findings published in the Sept. 8 issue of The Lancet.

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Heart Disease Patients' Families Should Be Screened

FRIDAY, Sept. 7 (HealthDay News) -- Screening the families of premature heart disease patients could prevent more than one-third of premature heart attacks, according to the results of a study published in the Sept. 8 issue of BMJ.

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Gene Variant Linked to Increased Human Stature

THURSDAY, Sept. 6 (HealthDay News) -- A common variant in the HMGA2 oncogene is associated with increased height in children and adults, according to the results of a study published online Sept. 2 in Nature Genetics.

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Newer Cell Phones Still Interrupt Medical Equipment

THURSDAY, Sept. 6 (HealthDay News) -- New-generation mobile phones should still be kept at least one meter away from hospital equipment, as they can cause electromagnetic interference with critical care devices, according to a report published online Sept. 6 in Critical Care.

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FDA Grants Approval for Generic Versions of Coreg

THURSDAY, Sept. 6 (HealthDay News) -- The U.S. Food and Drug Administration has granted approval to companies to manufacture the first generic versions of Coreg (carvedilol) for the treatment of high blood pressure, mild to severe chronic heart failure and left ventricular dysfunction after myocardial infarction.

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New Atrial Fibrillation Treatments Found Effective

WEDNESDAY, Sept. 5 (HealthDay News) -- Dronedarone, a new antiarrhythmic agent, and dual-chamber minimal ventricular pacing are effective treatments for patients with atrial fibrillation, according to two studies published in the Sept. 6 issue of the New England Journal of Medicine.

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Procrit Does Not Reduce Need for Transfusion in Critically Ill

WEDNESDAY, Sept. 5 (HealthDay News) -- Procrit (epoetin alfa) does not reduce the need for a blood transfusion in patients in the intensive care unit, although it may lower mortality in trauma patients and increase hemoglobin concentration and thrombotic events, according to the results of a trial published in the Sept. 6 issue of the New England Journal of Medicine.

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Drug Duo May Cut Diabetes-Related Mortality

WEDNESDAY, Sept. 5 (HealthDay News) -- Patients with type 2 diabetes who take the angiotensin-converting enzyme inhibitor perindopril and the diuretic indapamide are at reduced risk for major vascular events compared with those who do not take the combination therapy, according to study findings published online Sept. 2 in The Lancet.

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Resident Work-Hour Limits May Have Improved Mortality

TUESDAY, Sept. 4 (HealthDay News) -- Resident work-hour reform, implemented by the Accreditation Council for Graduate Medical Education in 2003, does not appear to have had a negative effect on patient outcomes and may actually have improved mortality rates, according to two studies published in the Sept. 5 issue of the Journal of the American Medical Association.

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Poor Bedside Manner Linked to Patient Complaints

TUESDAY, Sept. 4 (HealthDay News) -- Physicians with the lowest patient communication scores on a national clinical skills exam are more likely to have a patient complain to regulatory authorities than physicians with high scores, according to study findings published in the Sept. 5 issue of the Journal of the American Medical Association.

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When Ambulances Travel Farther, Deaths Increase

MONDAY, Sept. 3 (HealthDay News) -- Longer ambulance trips to the hospital are associated with greater risk of mortality among severely ill patients, researchers report in the September issue of the Emergency Medicine Journal.

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