September 2011 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for September 2011. 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.

Aspirin Resistance Is Relatively Common Phenomenon

FRIDAY, Sept. 30 (HealthDay News) -- Aspirin resistance is common, but poor compliance may contribute to a substantial number of cases of apparent resistance, according to a study published in the October issue of Cardiovascular Therapeutics.

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Doctors, Patients Identify Tacit Clues in Their Interactions

FRIDAY, Sept. 30 (HealthDay News) -- Both doctors and patients identify tacit clues as well as judgments based on these clues during video elicitation interviews of health maintenance examinations, according to a study published in the October issue of the Journal of Evaluation in Clinical Practice.

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SSRI With Antiplatelet Therapy Ups Post-MI Bleeding Risk

THURSDAY, Sept. 29 (HealthDay News) -- Combined use of selective serotonin reuptake inhibitors (SSRIs) with antiplatelet agents, including acetylsalicylic acid (ASA), clopidogrel, or both, is associated with an increased risk of bleeding following acute myocardial infarction (MI), according to a study published online Sept. 26 in CMAJ, the journal of the Canadian Medical Association.

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Food Patterns Tied to Systemic and Vascular Inflammation

THURSDAY, Sept. 29 (HealthDay News) -- Diets rich in high-fiber, low-fat, and low-sugar foods are favorably associated with markers of inflammation, whereas milk fat and sweets and cakes patterns are associated with adverse effects, according to a study published in the October issue of the Journal of Internal Medicine.

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Prehypertension Tied to Higher Risk of Incident Stroke

THURSDAY, Sept. 29 (HealthDay News) -- Individuals with prehypertension are at significant risk of incident stroke, with the risk increasing substantially among those with higher prehypertensive values, according to a meta-analysis published online Sept. 28 in Neurology.

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AHA: Tools, Challenges for Assessing Adiposity Identified

WEDNESDAY, Sept. 28 (HealthDay News) -- Body mass index (BMI) and waist circumference (WC) should be used as primary tools for assessing adiposity, according to an American Heart Association scientific statement published online Sept. 26 in Circulation.

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Operator Experience Tied to Carotid Stenting Mortality Risk

TUESDAY, Sept. 27 (HealthDay News) -- Carotid stenting in older patients performed by operators with low annual volume or less experience is associated with higher 30-day mortality risk, according to a study published in the Sept. 28 issue of the Journal of the American Medical Association.

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U.S. Docs Feel They Give More Patient Care Than Required

TUESDAY, Sept. 27 (HealthDay News) -- Many primary care physicians in the United States believe that their patients are receiving too much medical care, and that the pressure to do more than is necessary could be reduced by malpractice reform, adjusting financial incentives, and spending more time with patients, according to a study published in the Sept. 26 issue of the Archives of Internal Medicine.

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Abnormal Heart Rate Recovery Tied to Higher Mortality

TUESDAY, Sept. 27 (HealthDay News) -- Abnormal heart rate recovery (HRR) after undergoing a cardiac rehabilitation (CR) exercise program is associated with higher all-cause mortality, but patients who had abnormal HRR at baseline and normalized HRR after completing the program have similar mortality to patients with a normal baseline HRR, according to a study published online Sept. 26 in Circulation.

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Reasons for Referral to Specific Docs Differ Among Physicians

TUESDAY, Sept. 27 (HealthDay News) -- Primary care physicians (PCPs) and medical and surgical specialists differ in their reasons for selecting specific colleagues for referrals, with PCPs more concerned about physician communication and medical record sharing than specialists, according to a study published online Sept. 16 in the Journal of General Internal Medicine.

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Cardiovascular Death Risk Increased for Childless Men

MONDAY, Sept. 26 (HealthDay News) -- Married childless men have an increased risk of death from cardiovascular disease developing after age 50 compared with men who have two or more offspring, according to a study published online Sept. 26 in Human Reproduction.

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Cardiac Rehab Effective for Secondary Prevention After TIA

FRIDAY, Sept. 23 (HealthDay News) -- Comprehensive cardiac rehabilitation (CCR) is effective for patients who have sustained a transient ischemic attack or mild, non-disabling stroke (TIA/MNDS) resulting in significant, favorable outcomes in vascular risk factors including aerobic capacity, total cholesterol, total cholesterol/high-density lipoprotein percentage, triglycerides, waist circumference, body mass index, and body weight, according to a study published online Sept. 22 in Stroke.

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SNP in SUV39H2 Tied to Complications in Diabetes

THURSDAY, Sept. 22 (HealthDay News) -- The minor T-allele of exonic single nucleotide polymorphism (SNP) rs17353856 in SUV39H2 is associated with retinopathy in patients with type 1 diabetes, and shows a trend toward an association with diabetic nephropathy and cardiovascular disease, according to a study published online Sept. 6 in Diabetes.

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Nocturnal Hypertension Ups cIMT in Youth With Diabetes

THURSDAY, Sept. 22 (HealthDay News) -- Nocturnal hypertension in children and adolescents with type 1 diabetes is associated with increased carotid intima-media thickness (cIMT), according to a study published online Sept. 12 in Diabetes Care.

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Aortic Arch Plaques More Prevalent in Aortic Stenosis

THURSDAY, Sept. 22 (HealthDay News) -- Patients with severe aortic stenosis (AS) have a greater prevalence of aortic arch plaques and complex arch plaques, with the presence of complex plaques independently associated with the risk of cerebral infarction, according to a study published in the Oct. 1 issue of The American Journal of Cardiology.

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Risk Up for Patients During Long Interdialytic Interval

WEDNESDAY, Sept. 21 (HealthDay News) -- For patients receiving hemodialysis, mortality and adverse cardiovascular-related events occur mainly on the day after the long interdialytic interval, rather than on other days, according to a study published in the Sept. 22 issue of the New England Journal of Medicine.

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Exposure to Air Pollution Found to Up Transient Risk of MI

WEDNESDAY, Sept. 21 (HealthDay News) -- Short-term exposure to particles with a diameter <10 µm (PM10) and nitrogen dioxide (NO2) in the air is associated with a short-term increased risk of myocardial infarction (MI) one to six hours later, according to a study published online Sept. 20 in BMJ.

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Preterm Birth Ups Mortality Risk in Young Adulthood

WEDNESDAY, Sept. 21 (HealthDay News) -- Low gestational age at birth is associated with increased mortality in young adulthood, according to a study published in the Sept. 21 issue of the Journal of the American Medical Association.

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Mortality Up in Hospitals With More Minority Trauma Patients

WEDNESDAY, Sept. 21 (HealthDay News) -- The odds of in-hospital mortality for trauma patients are associated with the proportion of minority patients in the hospital, according to a study published online Sept. 19 in the Archives of Surgery.

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Platelet Reactivity Status Predicts Ischemic Event Risk

TUESDAY, Sept. 20 (HealthDay News) -- High residual platelet reactivity (HRPR) after clopidogrel loading is significantly associated with an increased risk of short- and long-term ischemic events in patients receiving platelet reactivity-guided antithrombotic medication after percutaneous coronary intervention (PCI), according to a study published in the Sept. 21 issue of the Journal of the American Medical Association.

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Chronic Total Occlusion PCI Improves Outcomes in Diabetes

TUESDAY, Sept. 20 (HealthDay News) -- Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) is associated with reduced mortality and reduced need for coronary artery bypass grafting in patients with diabetes mellitus (DM), according to a study published in the Oct. 1 issue of The American Journal of Cardiology.

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Payer Status Affects Health Care Quality and Outcomes

TUESDAY, Sept. 20 (HealthDay News) -- Patients with heart failure who have no insurance, or have Medicaid or Medicare, have lower quality of care and worse outcomes than those with private/health maintenance organization (HMO) insurance, according to a study published in the Sept. 27 issue of the Journal of the American College of Cardiology.

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Treatment Delays Identified in Regional STEMI Systems

TUESDAY, Sept. 20 (HealthDay News) -- Treatment delays occur in standardized regional systems for transfer of patients with ST-segment-elevation myocardial infarction (STEMI) to receive primary percutaneous coronary intervention (PCI), with delays most frequently occurring at the referral hospital, PCI center, and during the transport process, according to a study published online Sept. 19 in Circulation.

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Work Intensity Similar Across Physician Specialties

MONDAY, Sept. 19 (HealthDay News) -- The level of physician work intensity appears to be similar among specialties, with variations in the specific dimensions of stress, physical demands, performance, and temporal demand, according to a study published online Sept. 3 in Medical Care.

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Enoxaparin Bests Unfractionated Heparin in Occlusive PAD

MONDAY, Sept. 19 (HealthDay News) -- Intravenous enoxaparin is safe and more effective than unfractionated heparin (UFH) for treating peripheral arterial occlusive disease (PAOD), according to a study published online Sept. 12 in the Journal of Thrombosis and Haemostasis.

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Thrombomodulin Gene Variants Up Post-CABG Mortality Risk

FRIDAY, Sept. 16 (HealthDay News) -- Genetic variants in the thrombomodulin gene (THBD) are independently associated with an increased risk of long-term all-cause mortality after coronary artery bypass graft (CABG) surgery, according to a study published in the Sept. 13 issue of Circulation.

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Xanthelasmata Predict Death, Ischemic Vascular Disease

FRIDAY, Sept. 16 (HealthDay News) -- Xanthelasmata either individually or in combination with arcus corneae, but not arcus corneae alone, predict the risk of ischemic vascular disease and death in the general population, according to a study published online Sept. 15 in BMJ.

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Statins After Ischemic Stroke Not Tied to Brain Hemorrhage

FRIDAY, Sept. 16 (HealthDay News) -- Exposure to statins after acute ischemic stroke is not associated with intracerebral hemorrhage (ICH), according to a study published online Sept. 12 in the Archives of Neurology.

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Child Self-Exposure to Meds Explains Most Drug Poisoning

FRIDAY, Sept. 16 (HealthDay News) -- Child self-exposure to prescription medications was responsible for 95 percent of the cases of pediatric pharmaceutical poisonings between 2001 and 2008, with the greatest resource use and morbidity due to self-ingestion of prescription products, including opioids, sedative-hypnotics, and cardiovascular agents, according to a study published online Sept. 16 in The Journal of Pediatrics.

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White Fruits, Vegetables Tied to Lower Incident Stroke Risk

FRIDAY, Sept. 16 (HealthDay News) -- Higher consumption of white fruits and vegetables is associated with a lower risk of incident stroke, according to a study published online Sept. 15 in Stroke.

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Anti-Nausea Drug May Lead to Dangerous Heart Rhythms

THURSDAY, Sept. 15 (HealthDay News) -- Zofran (ondansetron), used to prevent nausea in patients receiving cancer treatment, is undergoing an ongoing safety review and labeling change by the U.S. Food and Drug Administration because it may cause potentially fatal changes in heart rhythm, according to a Sept. 15 FDA safety alert.

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Tissue Factor Pathway Inhibitor Levels Up in Women With MI

THURSDAY, Sept. 15 (HealthDay News) -- Young women with myocardial infarction (MI) have higher tissue factor pathway inhibitor (TFPI) levels in comparison to those without MI, with increased TFPI activities and activated protein C (APC)-sensitivity correlating with MI, according to a study published online Sept. 5 in the Journal of Thrombosis and Haemostasis.

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Modifiable Lifestyle Factors Tied to Heart Failure Risk

WEDNESDAY, Sept. 14 (HealthDay News) -- Modifiable lifestyle factors, including smoking, body mass index (BMI), physical activity, and vegetable consumption, decrease the risk of heart failure in Finnish men and women, according to a study published online Sept. 13 in Circulation: Heart Failure.

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Many Mistakenly Believe FDA OKs Only Safe, Effective Drugs

WEDNESDAY, Sept. 14 (HealthDay News) -- A considerable proportion of the U.S. public mistakenly believes that the U.S. Food and Drug Administration approves only effective and safe drugs, but providing consumer explanations can lead to better drug choices, according to a study published in the Sept. 12 issue of the Archives of Internal Medicine.

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Erectile Dysfunction Ups Risk of Cardiovascular Disease

WEDNESDAY, Sept. 14 (HealthDay News) -- Erectile dysfunction (ED) significantly increases the risk of cardiovascular disease (CVD), coronary heart disease, stroke, and all-cause mortality, according to a meta-analysis published in the Sept. 20 issue of the Journal of the American College of Cardiology.

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Prehypertension-Hypertension Conversion Rate Tied to Race

WEDNESDAY, Sept. 14 (HealthDay News) -- Conversion from prehypertension to hypertension is more accelerated in blacks than in whites, according to a study published online Sept. 12 in Hypertension.

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Congenital Heart Disease Ups Endotoxemia Risk in Children

WEDNESDAY, Sept. 14 (HealthDay News) -- Children undergoing surgery for congenital heart disease are at an increased risk of intestinal mucosal injury, endotoxemia, and activation of endotoxin signaling pathways that are associated with adverse outcome, according to a study published online Aug. 25 in the American Journal of Respiratory and Critical Care Medicine.

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Aortic Dissection Incidence Higher in Individuals With BAV

TUESDAY, Sept. 13 (HealthDay News) -- Aortic dissection incidence is higher in individuals with bicuspid aortic valves (BAVs) than in the general population, according to a study published in the Sept. 14 issue of the Journal of the American Medical Association.

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Computer Nutrition Program Doesn't Affect Blood Lipids

TUESDAY, Sept. 13 (HealthDay News) -- Use of a computer-tailored nutrition education intervention does not affect blood lipid levels any differently than generic nutrition information, according to a study published in the September issue of the Journal of Nutrition Education and Behavior.

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Dalcetrapib Use Safe, Possibly Beneficial in Atherosclerosis

TUESDAY, Sept. 13 (HealthDay News) -- Dalcetrapib is safe and reduces change in total vessel area and most-diseased-segment target-to-background ratio (TBR) as revealed by magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET/CT), according to a study published online Sept. 12 in The Lancet.

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Metabolic Syndrome Beats Obesity for Heart Failure Risk

TUESDAY, Sept. 13 (HealthDay News) -- Obese individuals who are metabolically healthy have a lower risk of heart failure than those with metabolic syndrome (MetS) who are normal weight, according to a study published in the Sept. 20 issue of the Journal of the American College of Cardiology.

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Clopidogrel Adherence Tied to Daily Pre-PCI Med Adherence

MONDAY, Sept. 12 (HealthDay News) -- Low patient adherence to daily medication regimens before percutaneous coronary intervention (PCI) is a good predictor of low clopidogrel adherence after PCI, according to a study published in the Sept. 15 issue of The American Journal of Cardiology.

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Arterial Calcification Tied to Vascular Brain Disease

FRIDAY, Sept. 9 (HealthDay News) -- Arterial calcification in various vessel beds is associated with larger white matter lesion (WML) volume and the presence of cerebral infarcts, according to a study published online Aug. 25 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Cardiac Mortality Rates in Women Progress at Constant Rate

THURSDAY, Sept. 8 (HealthDay News) -- Heart disease mortality rates in women progress at a constant rate as they age, which contradicts the belief that the risk of cardiovascular death for women increases sharply after menopause, according to a study published online Sept. 6 in BMJ.

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Commercial Program Offers More Weight Loss Than Standard Care

THURSDAY, Sept. 8 (HealthDay News) -- Obese or overweight participants in a commercial weight loss program lose twice as much weight over a 12 month period than those in standard treatment, according to a study published online Sept. 8 in The Lancet.

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Comparative Efficacy Proposed for European Drug Approval

WEDNESDAY, Sept. 7 (HealthDay News) -- New drugs should be compared with existing treatments instead of placebo before their approval in Europe, according to a report published online Sept. 6 in the BMJ.

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Many Hospital Staff Uniforms Contaminated With Bacteria

WEDNESDAY, Sept. 7 (HealthDay News) -- More than 60 percent of hospital staff uniforms are contaminated with potentially pathogenic bacteria, including drug-resistant species, according to a study published in the September issue of the American Journal of Infection Control.

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Medical Students Show Racial, Cultural Patient Preference

WEDNESDAY, Sept. 7 (HealthDay News) -- Medical students may have a preferential bias toward whites and wealthier patients, but this does not appear to influence their clinical decision making or physician-patient interactions, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Odds of Board Certification Vary in New Doctors

WEDNESDAY, Sept. 7 (HealthDay News) -- Certification of recent U.S. medical school graduates by the American Board of Medical Specialties (ABMS) varies across specialties by educational and demographic factors, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.

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Prevalence of U.S. Smokers Down Substantially Since 2005

TUESDAY, Sept. 6 (HealthDay News) -- Adult cigarette smoking in the United States has decreased since 2005, particularly among heavy smokers; there is still, however, room for improvement, according to a report published in the Sept. 6 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Palliative Coronary Stenting Safe and Feasible in Infants

TUESDAY, Sept. 6 (HealthDay News) -- Coronary artery stent implantation is a feasible and safe palliative option in infants and young children with coronary artery stenosis, according to a study published online Aug. 30 in Catheterization and Cardiovascular Interventions.

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Lower Sleep-Time BP Indicates Reduced Cardiovascular Risk

FRIDAY, Sept. 2 (HealthDay News) -- The asleep blood pressure mean, determined by ambulatory monitoring, independently predicts cardiovascular risk, with a progressive decrease in asleep blood pressure predicting a significantly reduced cardiovascular risk, according to a study published in the Sept. 6 issue of the Journal of the American College of Cardiology.

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Increase in Infection Incidence With Cardiac Device Implants

THURSDAY, Sept. 1 (HealthDay News) -- The incidence of infection in patients with cardiac implantable electrophysiological devices (CIEDs) remained constant from 1993 to 2004, and increased from 2004 to 2008, according to a study published in the Aug. 30 issue of the Journal of American College of Cardiology.

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