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September 2008 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for September 2008. 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.

News Media Under-Report Drug Company Funding of Research

TUESDAY, Sept. 30 (HealthDay News) -- Reports on medication research published in general news media often fail to disclose that the research received pharmaceutical company funding and frequently refer to drugs by brand name rather than using the generic name, according to an article published in the Oct. 1 issue of the Journal of the American Medical Association.

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Electrocardiogram Finding in Ventricular Fibrillation

TUESDAY, Sept. 30 (HealthDay News) -- J-point elevation is more common in the electrocardiograms of patients with idiopathic ventricular fibrillation than healthy individuals and athletes, according to the results of a study in the Oct. 7 issue of the Journal of the American College of Cardiology.

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Time to Procedure After Heart Attack Should Be Increased

TUESDAY, Sept. 30 (HealthDay News) -- The recommended time to primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) should be increased from under 90 minutes to 90 to 120 minutes based on current evidence, according to a commentary in the Oct. 7 issue of the Journal of the American College of Cardiology.

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Depression Screening Urged for Heart Patients

TUESDAY, Sept. 30 (HealthDay News) -- Because coronary heart disease is often accompanied by depression, clinicians should aggressively screen patients for symptoms of depression and provide appropriate treatment, according to an American Heart Association Science Advisory published online Sept. 29 in Circulation: Journal of the American Heart Association.

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Hyperuricemia Predicts Cardiac Risk in Surgical Patients

TUESDAY, Sept. 30 (HealthDay News) -- Hyperuricemia in patients undergoing vascular surgery is predictive of late mortality and major adverse cardiac events, but not 30-day mortality, researchers report in the Oct. 1 issue of the American Journal of Cardiology.

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Biventricular Assist Device Shows Promise in Children

TUESDAY, Sept. 30 (HealthDay News) -- The use of biventricular assist devices may be an effective method for sustaining small children awaiting heart transplantation, according to research published Sept. 30 in a supplement issue of Circulation: Journal of the American Heart Association.

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Statins Don't Raise Risk of Amyotrophic Lateral Sclerosis

TUESDAY, Sept. 30 (HealthDay News) -- Using statins does not raise the risk of developing amyotrophic lateral sclerosis (ALS), according to research conducted by the U.S. Food and Drug Administration and published online Sept. 29 in Pharmacoepidemiology and Drug Safety.

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Resident-Led Heart Surgeries Not Linked to Worse Outcomes

TUESDAY, Sept. 30 (HealthDay News) -- Cardiac surgeries performed by senior-level residents resulted in similar long-term event-free survival as procedures performed by staff surgeons, according to research published Sept. 30 in a supplement issue of Circulation: Journal of the American Heart Association.

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Periodic Fasting May Decrease Cardiac Risk

MONDAY, Sept. 29 (HealthDay News) -- Both the proscription of tobacco products and periodic fasting may lower the risk of coronary artery disease, according to the results of a study published in the Oct. 1 issue of the American Journal of Cardiology.

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Exercise Helps with Smoking Cessation in Pregnancy

MONDAY, Sept. 29 (HealthDay News) -- A physical activity intervention to help pregnant women stop smoking appears to be feasible and beneficial, according to study results published in the Sept. 23 issue of BMC Public Health.

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Joint Commission Issues Anticoagulant Event Alert

MONDAY, Sept. 29 (HealthDay News) -- Specific risk reduction strategies can help prevent errors in the administration of anticoagulants that often result in harm or death, according to a Sentinel Event Alert published Sept. 24 by The Joint Commission, which accredits and certifies more than 15,000 health care organizations and programs in the United States.

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Platelet Reactivity Levels May Predict Coronary Risk

FRIDAY, Sept. 26 (HealthDay News) -- High residual platelet reactivity after clopidogrel administration prior to percutaneous coronary intervention (PCI) is associated with higher incidence of 30-day major adverse cardiac events, according to a report published in the Sept. 30 issue of the Journal of the American College of Cardiology.

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Isoflavone Improves Endothelial Function

FRIDAY, Sept. 26 (HealthDay News) -- Isoflavone supplementation reverses endothelial dysfunction and may prove efficacious in the secondary prevention of cardiovascular diseases, according to a report published online Sept. 23 in the European Heart Journal.

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Adding Intervention Not Cost Effective in Coronary Disease

THURSDAY, Sept. 25 (HealthDay News) -- In patients with stable coronary artery disease, the addition of percutaneous coronary intervention (PCI) to optimal medical therapy is not a cost-effective initial management strategy, and treating patients with established vascular disease is associated with a substantial economic burden, according to two studies published in the September issue of Circulation: Cardiovascular Quality and Outcomes.

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Implantable Cardioverter-Defibrillators Re-Examined

THURSDAY, Sept. 25 (HealthDay News) -- There is a compelling rationale for clinicians to critically analyze evidence-based guidelines when using implantable cardioverter-defibrillators (ICDs) for the prevention of sudden cardiac death, according to a report published in the Sept. 30 issue of the Journal of the American College of Cardiology.

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Post-Surgical Risks Analyzed in Aortic Dissection

THURSDAY, Sept. 25 (HealthDay News) -- In patients with acute type B aortic dissection, a large maximal false lumen area and a higher branch-vessel involvement greatly increase the risk of in-hospital post-surgical complications, according to research published in the Sept. 30 issue of the Journal of the American College of Cardiology.

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Drug-Eluting Stents May Cut Mortality After Heart Attack

WEDNESDAY, Sept. 24 (HealthDay News) -- Two years after undergoing stenting for acute myocardial infarction, patients who received drug-eluting stents have significantly lower rates of death and repeat revascularization than those who received bare-metal stents, researchers report in the Sept. 25 issue of the New England Journal of Medicine.

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Media Firestorm Over Pediatric Statins Misses the Point

WEDNESDAY, Sept. 24 (HealthDay News) -- When the American Academy of Pediatrics released revised recommendations for the management of hypercholesterolemia in children this year, a media firestorm erupted over the inclusion of statins as potential first-line pharmacologic agents. But the epidemic of childhood obesity has forced pediatricians to balance the unknown risks associated with pharmacologic therapy in children against the risk that failure to treat could lead to heart attacks and other complications in young adulthood, according to a Perspective article published in the Sept. 25 issue of the New England Journal of Medicine.

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Heart Treatment Delays More Common in Poor, Underinsured

WEDNESDAY, Sept. 24 (HealthDay News) -- Disparities related to health insurance and socioeconomic status are associated with excessive time delays that may impede effective treatment for acute myocardial infarction, researchers report in the Sept. 22 issue of the Archives of Internal Medicine.

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Time Between Stent, Later Surgery Linked to Lower Risk

WEDNESDAY, Sept. 24 (HealthDay News) -- In patients who have undergone bare-metal stent implantation, the risk of major cardiac events with a subsequent non-cardiac surgery is lower if at least three months have passed after the stent intervention; for drug-eluting stents, rates of major cardiac events with subsequent surgeries showed a trend toward being lowest after a year, according to the results of two studies published in the October issue of Anesthesiology.

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Inhaled Anticholinergics Increase Cardiovascular Risk

TUESDAY, Sept. 23 (HealthDay News) -- Use of inhaled anticholinergics raises the risk of cardiovascular death, heart attack or stroke in patients with chronic obstructive pulmonary disease (COPD), according to a meta-analysis published in the Sept. 24 issue of the Journal of the American Medical Association.

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Out-of-Hospital Cardiac Arrest Outcomes Differ

TUESDAY, Sept. 23 (HealthDay News) -- There were significant differences in survival of out-of-hospital cardiac arrest cases treated by emergency medical services (EMS) across North American cities, according to a study published in the Sept. 24 issue of the Journal of the American Medical Association. The American Heart Association guidelines may enable identification of appropriate cases for increased cardiopulmonary resuscitative efforts, according to another study.

Abstract - Nichol
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Abstract - Sasson
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American Indians Have More Strokes Than US Whites, Blacks

TUESDAY, Sept. 23 (HealthDay News) -- American Indians have a higher incidence of stroke, as well as a higher case-fatality rate following a first stroke, than some other segments of the U.S. population, according to an article published online Sept. 22 in Circulation: Journal of the American Heart Association.

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No Racial or Gender Bias in Time to Electrocardiogram

TUESDAY, Sept. 23 (HealthDay News) -- Among chest pain cases presenting at hospital emergency departments, there are no racial or gender disparities in terms of time from admission to electrocardiogram (EKG), but patients over the age of 60 tend to be tested more promptly than their younger counterparts, according to a report published in the October issue of the Journal of Emergency Nursing.

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Passive Smoking Linked to Peripheral Arterial Disease

TUESDAY, Sept. 23 (HealthDay News) -- Secondhand smoke appears to be a risk factor for peripheral arterial disease in older Chinese women who have never smoked, according to research published online Sept. 22 in Circulation: Journal of the American Heart Association.

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Thyroid Dysfunction Linked to Heart Failure in Elderly

TUESDAY, Sept. 23 (HealthDay News) -- Elderly individuals with severe subclinical hypothyroidism have a higher incidence of heart failure, according to study findings published in the Sept. 30 issue of the Journal of the American College of Cardiology.

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White Coat Hypertension Has Lower Mortality Risk

MONDAY, Sept. 22 (HealthDay News) -- The mortality rate associated with white coat hypertension is significantly lower than that associated with sustained hypertension, according to a report in the September/October issue of the Annals of Family Medicine.

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No Change to 2009 Part B Medicare Premium

MONDAY, Sept. 22 (HealthDay News) -- There will be no change to the Part B Standard Medicare premium in 2009 compared with 2008. This is the first time since 2000 that the premium has not risen over the prior year, according to an announcement by the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS).

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Antibiotic Resistance Has Become a Global Pandemic

FRIDAY, Sept. 19 (HealthDay News) -- A concerted international and national response, behavior change by consumers and providers, and the development of antibacterial agents are all urgently needed to tackle the global problem of rapidly increasing antibiotic resistance, according to an article published online Sept. 18 in BMJ.

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MRI Can Detect Carotid Plaque Hemorrhage

THURSDAY, Sept. 18 (HealthDay News) -- MRI offers a non-invasive method of assessing intraplaque hemorrhage in carotid arteries to identify patients at greater risk of atherosclerotic disease, according to a report in the October issue of Radiology.

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History, Physical Exam Provide Accurate Cardiac Estimates

THURSDAY, Sept. 18 (HealthDay News) -- Estimates of hemodynamic parameters from a history and physical exam are largely accurate and can predict death or rehospitalization in patients with advanced heart failure, according to study findings published in the September issue of Circulation: Heart Failure.

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Cardiac Ultrasound Identifies Low-Risk Patients

THURSDAY, Sept. 18 (HealthDay News) -- Despite the cost of performing myocardial contrast echocardiography (MCE) in all patients with suspected cardiac chest pain and a non-diagnostic electrocardiogram (ECG), MCE can identify low-risk patients with non-cardiac chest pain that can safely be discharged and potentially reduce unnecessary hospitalizations and costs, according to the results of a study published in the Sept. 15 issue of the American Journal of Cardiology.

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Medical Home Concept Needs Wide Support to Succeed

WEDNESDAY, Sept. 17 (HealthDay News) -- The 'medical home' model, whereby patients can enjoy coordinated primary care within a patient-centered practice model, must overcome several obstacles in order to succeed, according to an article published in the Sept. 18 issue of the New England Journal of Medicine.

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Healthy Middle-Age Lifestyle Halves Women's Risk of Death

WEDNESDAY, Sept. 17 (HealthDay News) -- Middle-aged women who avoid smoking, maintain a healthy body weight, get regular exercise and eat a diet low in red meat and trans-fats can reduce their risk of premature death by more than half, according to study findings published online Sept. 16 in BMJ.

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Beta-Blockers Reduce Risk of Heart Failure in Hypertension

WEDNESDAY, Sept. 17 (HealthDay News) -- Although beta-blockers are effective in lowering blood pressure and reduce the risk of heart failure in patients with hypertension, they do not have incremental benefit compared with other antihypertensive drugs and increase the risk of stroke in the elderly, researchers report in the Sept. 23 issue of the Journal of the American College of Cardiology.

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Factors Associated with Plavix Response Identified

WEDNESDAY, Sept. 17 (HealthDay News) -- Obesity, diabetes mellitus and elevated plasma fibrinogen are associated with reduced platelet inhibition in patients with cardiovascular disease treated with clopidogrel (Plavix), according to the results of a study published in the Sept. 23 issue of the Journal of the American College of Cardiology.

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Bicuspid Aortic Valve Linked to Primary Cardiac Events

TUESDAY, Sept. 16 (HealthDay News) -- Young adults with bicuspid aortic valve -- the most common congenital cardiac anomaly in the adult population -- may have an increased risk of primary cardiac events. But their survival rate is similar to that of the general population, researchers report in the Sept. 17 issue of the Journal of the American Medical Association.

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Bisphenol A Concentrations Linked to Chronic Diseases

TUESDAY, Sept. 16 (HealthDay News) -- People with higher urinary levels of Bisphenol A (BPA) -- a chemical compound widely used in epoxy resins lining food and beverage containers -- may have an increased risk of cardiovascular disease, type 2 diabetes and liver-enzyme abnormalities, researchers report in the Sept. 17 issue of the Journal of the American Medical Association.

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Link Between Migraine and Atherosclerosis Is Debunked

TUESDAY, Sept. 16 (HealthDay News) -- Migraine patients do not have a higher risk of atherosclerosis than other patients, but they appear to have a higher risk of venous thromboembolism, according to research published in the Sept. 16 issue of Neurology.

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Drug-Eluting Stents Linked to Lower Death Risk

TUESDAY, Sept. 16 (HealthDay News) -- The use of drug-eluting stents is associated with a lower risk of death compared with bare-metal stents in patients undergoing percutaneous coronary intervention, according to the results of a study published in the Sept. 23 issue of the Journal of the American College of Cardiology.

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Brain Natriuretic Peptide Predicts Valvular Disease Outcome

TUESDAY, Sept. 16 (HealthDay News) -- Both the calculated logistic EuroSCORE (logES) and an elevated brain natriuretic peptide (BNP) predict mortality in patients with symptomatic aortic stenosis, researchers report in the September issue of the American Journal of Cardiology.

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Newer Schizophrenia Drugs May Have Metabolic Side Effects

MONDAY, Sept. 15 (HealthDay News) -- Second-generation, or atypical, antipsychotic drugs used to treat children and adolescents with early-onset schizophrenia or schizo-affective disorder are not necessarily superior to first-generation drugs, according to an article published online Sept. 15 in the American Journal of Psychiatry.

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Alteplase Still Safe Treatment Up to 4.5 Hours

MONDAY, Sept. 15 (HealthDay News) -- Although intravenous alteplase has been approved for use in stroke patients within three hours of onset, it can be safely and effectively used up to 4.5 hours after onset, according to the results of a study published online Sept. 15 in The Lancet.

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Drug Activates Protective Cardiac Enzyme in Rats

MONDAY, Sept. 15 (HealthDay News) -- A small molecule can activate a cardioprotective enzyme in rats and reduce infarct size after cardiac ischemia, which could be useful during coronary bypass surgery, according to research published in the Sept. 12 issue of Science.

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Day of Discharge Doesn't Affect Guideline Compliance

MONDAY, Sept. 15 (HealthDay News) -- Staff adherence to guideline recommendations when treating patients hospitalized with acute coronary syndrome is not affected by day of discharge (weekday versus weekend), researchers report in the Sept. 15 issue of the American Journal of Cardiology.

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Lab Test Ratio Predicts Risk Among Coronary Patients

MONDAY, Sept. 15 (HealthDay News) -- The neutrophil/lymphocyte ratio (NLR) is a comparatively inexpensive marker of inflammation that identifies high-risk patients and may allow for risk stratification of patients with acute coronary syndromes, according to a report in the Sept. 15 issue of the American Journal of Cardiology.

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Chronic Disease Is Heavy Burden in Developing World

FRIDAY, Sept. 12 (HealthDay News) -- Although many countries have made significant progress in reducing mortality, the burden of chronic and non-communicable disease remains heavy and requires integrated strategies to tackle it, according to three papers published in the Sept. 13 issue of The Lancet, which has a special focus on the legacy of the 1978 International Conference on Primary Health Care in Alma-Ata.

Abstract - Tollman
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Abstract - Lawn
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Abstract - Beaglehole
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Mediterranean Diet Lowers Risk of Death and Cancer

FRIDAY, Sept. 12 (HealthDay News) -- Adherence to a Mediterranean diet rich in fruits, vegetables, legumes, cereals and fish, and involving a moderate intake of red wine with meals is associated with a lower risk of death, cancer and Parkinson's and Alzheimer's disease, according to research published online Sept. 11 in BMJ.

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Many Pain Relievers Not Linked to Heart Risks

THURSDAY, Sept. 11 (HealthDay News) -- Many coxibs and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) don't appear to raise the risk of cardiovascular disease events, according to research published in the Aug. 15 issue of Arthritis Care & Research.

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Glucose Control Benefits Long-Lasting for Diabetics

WEDNESDAY, Sept. 10 (HealthDay News) -- In patients with type 2 diabetes, the benefits of blood pressure control are lost unless blood pressure control is maintained, while intensive glucose control has long-lasting benefits, according to two studies published online Sept. 10 in the New England Journal of Medicine.

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Diastolic Function Worse in Hypertensive Blacks

WEDNESDAY, Sept. 10 (HealthDay News) -- In patients with hypertension, diastolic function is significantly worse in African-Caribbeans than in white Europeans, according to the results of a study published in the Sept. 16 issue of Journal of the American College of Cardiology.

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Increasing Weight Raises Risk of Premature Heart Attack

TUESDAY, Sept. 9 (HealthDay News) -- Increasing adiposity decreases the age at which patients experience a first non-ST-segment elevation myocardial infarction (NSTEMI). Also, in obese diabetics, a very-low-calorie diet may decrease myocardial triglyceride content and improve diastolic function, according to two studies published in the Sept. 16 issue of Journal of the American College of Cardiology.

Abstract - Madala
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Abstract - Hammer
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Cardiac Patients Vulnerable to Effects of Air Pollution

TUESDAY, Sept. 9 (HealthDay News) -- Cardiac patients, particularly those who have been hospitalized within the past month due to a cardiac event, are vulnerable to the effects of air pollution, according to research published in the Sept. 23 issue of Circulation: Journal of the American Heart Association.

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Removing Samples Increases Generic Prescriptions

MONDAY, Sept. 8 (HealthDay News) -- Uninsured patients are three times more likely to be prescribed generic drugs when drug samples are removed from their physician's office, according to a report published in the September issue of the Southern Medical Journal.

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Shortage of Nuclear Imaging Agents May Delay Scans

MONDAY, Sept. 8 (HealthDay News) -- Heart imaging, bone scans and some cancer detection tests may be subject to delays or even cancellation due to a global shortage of medical isotopes, according to a letter and article published online Sept. 5 in BMJ.

Abstract - Perkins
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Abstract - Stafford
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Heavy Snoring Linked to Carotid Atherosclerosis

FRIDAY, Sept. 5 (HealthDay News) -- Heavy snoring is associated with a more than 10-fold higher risk of carotid atherosclerosis but not with femoral atherosclerosis, researchers report in the Sept. 1 issue of Sleep.

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Metabolic Syndrome Has Adverse Effects on Teens' Hearts

FRIDAY, Sept. 5 (HealthDay News) -- Among adolescents aged 14 to 20 years, those with the metabolic syndrome have a higher risk of developing heart problems than those without the metabolic syndrome, according to the results of a study of American Indian teens published in the Sept. 9 issue of the Journal of the American College of Cardiology.

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Study Analyzes Atorvastatin Use in Elderly Post-Stroke

THURSDAY, Sept. 4 (HealthDay News) -- Age does not affect efficacy in patients treated with atorvastatin for stroke or transient ischemic attack (TIA), according to a report published online Sept. 3 in Neurology.

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Defribrillator Improves Quality of Life in Heart Failure

WEDNESDAY, Sept. 3 (HealthDay News) -- Heart failure patients who receive an implantable cardioverter-defibrillator (ICD) have reduced mortality and report a good quality of life a year later compared with medical therapy, although patients who receive shocks also have a higher risk of death, according to two studies in the Sept. 4 issue of the New England Journal of Medicine.

Abstract - Mark
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Abstract - Poole
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Birth Weight Linked to Blood Pressure in Adulthood

WEDNESDAY, Sept. 3 (HealthDay News) -- Birth weight is associated with systolic blood pressure and rate of growth is associated with both systolic and diastolic blood pressure in adulthood, according to the results of a study of young adults published online Sept. 2 in Hypertension.

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Sodium Bicarbonate Not a Superior Hydration Strategy

TUESDAY, Sept. 2 (HealthDay News) -- In patients with moderate to severe chronic kidney disease who are undergoing coronary angiography, hydration with sodium bicarbonate is not superior to hydration with sodium chloride in preventing contrast medium-induced nephropathy, according to an article published in the Sept. 3 issue of the Journal of the American Medical Association.

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Intervention Beneficial in Stable Coronary Disease

TUESDAY, Sept. 2 (HealthDay News) -- Patients with stable coronary artery disease generally have better outcomes after percutaneous coronary intervention (PCI) than medical treatment, although PCI should only be performed under certain conditions in these patients, according to a study and a review in the Sept. 9 issue of the Journal of the American College of Cardiology.

Abstract - Schomig
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Abstract - Katritsis
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Intensive Statins Beneficial Based on Baseline Cholesterol

TUESDAY, Sept. 2 (HealthDay News) -- Intensive statin treatment is more beneficial in patients with an acute coronary syndrome whose baseline low-density lipoprotein cholesterol (LDL-C) is above 66 mg/dL, according to a report in the Sept. 9 issue of the Journal of the American College of Cardiology.

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Vytorin May Increase Cancer Risk

TUESDAY, Sept. 2 (HealthDay News) -- Ezetimibe plus simvastatin (Vytorin) may be associated with an increased risk of cancer, according to two studies published online Sept. 2 in the New England Journal of Medicine and presented at the European Society of Cardiology Congress held Aug. 30-Sept. 3 in Munich, Germany.

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Biolimus-Eluting Stent Offers Safe, Effective Alternative

TUESDAY, Sept. 2 (HealthDay News) -- In patients with chronic stable coronary artery disease or acute coronary syndromes, the use of a stent eluting biolimus from a biodegradable polymer may be a safe and effective alternative to a stent eluting sirolimus from a durable polymer, according to the results of a study published early online Sept. 1 in The Lancet and presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.

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Telmisartan Shows Modest Cardiovascular Benefit

MONDAY, Sept. 1 (HealthDay News) -- Telmisartan, an angiotensin-receptor blocker (ARB), is a potential option for patients intolerant of angiotensin-converting enzyme (ACE) inhibitors, although the cardiovascular benefits appear less robust, according to a study and editorial published online Aug. 31 in The Lancet and presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.

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Omega-3 Fatty Acids Reduce Heart Failure Mortality

MONDAY, Sept. 1 (HealthDay News) -- Omega-3 polyunsaturated fatty acids have beneficial effects on cardiovascular morbidity and mortality while treatment with rosuvastatin does not affect clinical outcomes in patients with chronic heart failure, according to two studies published online Aug. 31 in The Lancet and also presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.

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Ivabradine Improves Outcomes in Some Heart Patients

MONDAY, Sept. 1 (HealthDay News) -- Use of ivabradine, a heart-rate lowering drug, may improve outcomes in patients with coronary artery disease and a high heart rate, according to a study published online Aug. 31 in The Lancet and also presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany. A second study indicates that a higher resting heart rate in patients with heart disease is a strong, independent risk factor for death.

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Alcohol Tied to Lower Heart Failure Risk in Hypertensives

MONDAY, Sept. 1 (HealthDay News) -- Light to moderate alcohol intake was associated with a lower risk of heart failure in men with hypertension, according to research published in the September issue of the American Journal of Cardiology.

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