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Category: Cardiology | Monthly Briefing

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May 2009 Briefing - Cardiology

Last Updated: June 01, 2009.

 

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Here are what the editors at HealthDay consider to be the most important developments in Cardiology for May 2009. 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.

Links Between Bleeding, PCI, Mortality Explored

FRIDAY, May 29 (HealthDay News) -- Major bleeding may play a causal role in mortality in patients undergoing percutaneous coronary intervention (PCI), according to a paper published in the June 2 Journal of the American College of Cardiology.

Abstract
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Window for Stroke Treatment Opened to 4.5 Hours

FRIDAY, May 29 (HealthDay News) -- The clot-busting drug recombinant tissue plasminogen activator (rtPA) can be given to eligible stroke victims as long as 4.5 hours after onset of symptoms, according to a new scientific advisory published online May 28 in Stroke: Journal of the American Heart Association, but the American Heart Association (AHA)/American Stroke Association (ASA) still urge further analyses.

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Stimulant Gum Can Cause Caffeine Overdose

FRIDAY, May 29 (HealthDay News) -- Excessive consumption of stimulant chewing gum resulted in the hospitalization of a 13-year-old boy due to caffeine overdose, highlighting the hidden risk to children of such easily available products, according to a case report published in the May 30 issue of The Lancet.

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Vascular Disease Prevention Benefits of Aspirin Uncertain

FRIDAY, May 29 (HealthDay News) -- The benefits of using aspirin in the primary prevention of vascular disease are uncertain because it reduces the risk of heart attack but increases the risk of internal bleeding, according to a study published in the May 30 issue of The Lancet.

Abstract
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Editorial (subscription or payment may be required)

Beta Blocker Use Promotes Survival in Heart Disease

FRIDAY, May 29 (HealthDay News) -- Long-term use of beta blockers in patients with coronary artery disease and left ventricular dysfunction reduces the risk of death, according to a study in the June 1 issue of the American Journal of Cardiology.

Abstract
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Electrophysiology Predicts Tachycardia After Heart Failure

THURSDAY, May 28 (HealthDay News) -- Patients with ischemic cardiomyopathy who go on to develop ventricular tachycardia have differences in the electrophysiology and electroanatomy of the scarred areas, according to a study published online May 27 in the Journal of the American College of Cardiology.

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Editorial

Computerized Prescription Order Errors a Risk for Patients

THURSDAY, May 28 (HealthDay News) -- Computerized provider order entry systems are prone to input errors that may put patients at risk, according to a study published in the May 25 issue of the Archives of Internal Medicine.

Abstract
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Editorial (subscription or payment may be required)

Focus on Meaningful Work Protects Doctors From Burnout

THURSDAY, May 27 (HealthDay News) -- Academic faculty physicians who focus on what they find most meaningful are less likely to experience burnout, according to a study published in the May 25 issue of the Archives of Internal Medicine.

Abstract
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Statins Improve Long-Term Outcomes After First Stroke

WEDNESDAY, May 27 (HealthDay News) -- First-ever acute ischemic stroke patients who are prescribed statins after hospital discharge may have a significantly lower long-term risk of recurrent stroke or death, according to a study published in the May 26 issue of Neurology.

Abstract
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Repeat Caesareans Linked to Neonatal Respiratory Problems

WEDNESDAY, May 27 (HealthDay News) -- Infants born via elective repeat Caesarean delivery may face a higher risk of certain adverse outcomes, and the rate of delivery hospitalizations involving hypertensive disorders has risen significantly in recent years, according to two studies published in the June issue of Obstetrics & Gynecology.

Abstract - Kamath
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Abstract - Kuklina
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Obese and Diabetic Youth Have Carotid Abnormalities

WEDNESDAY, May 27 (HealthDay News) -- Young people who are obese or who have type 2 diabetes mellitus have abnormalities in the carotid artery that should serve as an alert to increased risk of stroke and myocardial infarction in adulthood, according to a study published online on May 26 in Circulation.

Abstract
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Hypertension Observed in Professional Football Players

TUESDAY, May 26 (HealthDay News) -- Compared to other healthy, young adult men, professional football players are less likely to have impaired fasting glucose but more likely to have hypertension, according to a study published in the May 27 issue of the Journal of the American Medical Association.

Abstract
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Dispatching Software Misses More Than Half of Strokes

TUESDAY, May 26 (HealthDay News) -- The telephone-based software used to prioritize emergency ambulance response failed to identify more than half the incidents of stroke over a six-month period, according to a study in the June Emergency Medicine Journal.

Abstract
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Triglyceride Level Associated with Diabetic Neuropathy

TUESDAY, May 26 (HealthDay News) -- The progression of diabetic neuropathy is associated with elevated triglycerides in the blood and with decreased conduction of the peroneal motor nerve, according to a study published online May 1 in Diabetes.

Abstract
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Intensive Glucose Lowering Reduces Diabetics' Heart Risks

FRIDAY, May 22 (HealthDay News) -- In patients with type 2 diabetes, an intensive glucose-lowering regimen significantly reduces coronary events without increasing the risk of death, according to a study published in the May 23 issue of The Lancet.

Abstract
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Echocardiography in CRT Patient Selection Controversial

FRIDAY, May 22 (HealthDay News) -- Research should continue into the use of echocardiography as a means to select candidates for implant of cardiac resynchronization therapy (CRT) devices, but QRS prolongation remains the recommended criterion in making that decision. That was the apparent consensus of a trio of papers arguing the question in the May 26 issue of the Journal of the American College of Cardiology.

Full Text - Bax & Gorcsan (subscription may be required)
Abstract - Hawkins
Full Text - Hawkins (subscription may be required)
Editorial - Sanderson (subscription may be required)

Exercise Echocardiography Can Predict Cardiac Events, Death

THURSDAY, May 21 (HealthDay News) -- Exercise echocardiography (EE) can help predict major cardiac events and mortality in patients who appear normal on electrocardiogram (ECG) tests, according to a study in the May 26 Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Democrats Set Ambitious Goal for Health Care Reform

THURSDAY, May 21 (HealthDay News) -- Congressional Democrats face formidable challenges in their efforts to pass health care reform legislation by July 31, but physicians can take the lead to ensure changes are enacted, according to two perspectives published online May 20 in the New England Journal of Medicine.

Full Text - Iglehart
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Hybrid Revascularization Procedures Seem Feasible

THURSDAY, May 21 (HealthDay News) -- A hybrid approach to treating carotid and coronary artery disease with back-to-back procedures may be a feasible therapeutic strategy, according to research published in the May issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

Abstract
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Editorial (subscription or payment may be required)

ARBs Found Ineffective for Renal Function in Diabetes

THURSDAY, May 21 (HealthDay News) -- Two angiotensin receptor blockers are ineffective in reducing renal dysfunction in patients at high risk of vascular disease such as diabetics, according to two studies published online May 19 in the Annals of Internal Medicine.

Abstract - Mann
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Abstract - Bilous
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Sticking to Work Hours Limits Very Costly

WEDNESDAY, May 20 (HealthDay News) -- Adherence to the 2003 Accreditation Council for Graduate Medical Education (ACGME) limits on work hours, and other measures aimed at reducing fatigue among residents, would be costly with no proven benefits, according to an article published in the May 21 issue of the New England Journal of Medicine.

Abstract
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Editorial

Dipyridamole Can Cut Risk of Hemodialysis Stenosis

WEDNESDAY, May 20 (HealthDay News) -- A combination of aspirin and dipyridamole can yield a modest reduction in the risk of arterovenous graft stenosis in patients undergoing hemodialysis, and can increase the duration of patency in new grafts, according to a study published in the May 21 issue of the New England Journal of Medicine.

Abstract
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Editorial

Early Angiography Benefits High-Risk Coronary Patients

WEDNESDAY, May 20 (HealthDay News) -- For high-risk patients with acute coronary syndrome, coronary angiography within hours after presentation can reduce the chance of subsequent death, heart attack and stroke, according to a study in the May 21 issue of the New England Journal of Medicine.

Abstract
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Editorial

Pain Management May Be Best Option for Critically Ill

WEDNESDAY, May 20 (HealthDay News) -- Pain management and end-of-life care may be the most beneficial treatment for patients in the intensive care unit (ICU) and should focus on communicating with the patient and family and clearing up misconceptions about the use of palliative treatments, according to a review in the May issue of Chest.

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Antihypertensive Drugs Also Benefit Non-Hypertensives

WEDNESDAY, May 20 (HealthDay News) -- In everyone at risk for heart attack or stroke -- including those with normal blood pressure -- antihypertensive treatment significantly reduces the risk of coronary heart disease events and stroke, according to a study published online May 19 in BMJ.

Abstract
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Editorial

Door-to-Balloon Delays Increase Risk of Death

WEDNESDAY, May 20 (HealthDay News) -- In patients admitted with ST elevation myocardial infarction, any delay in primary percutaneous coronary intervention is associated with an increased risk of death, according to a study published online May 19 in BMJ.

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Personalized Support Helps Improve Diet and Fitness

WEDNESDAY, May 20 (HealthDay News) -- An e-mail-based intervention with personalized content can help people eat more healthily and do more physical activity, according to a study published online May 19 in the American Journal of Preventive Medicine.

Abstract
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Findings Support Clopidogrel Guideline Recommendations

WEDNESDAY, May 20 (HealthDay News) -- The use of clopidogrel in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) is associated with suitable ischemic reduction and bleeding outcomes to support its use before cardiac catheterization, even if patients should need coronary artery bypass grafting (CABG), according to research published in the May 26 issue of the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

Cardiorespiratory Fitness Reduces Mortality Risk

TUESDAY, May 19 (HealthDay News) -- Healthy adults with good rates of cardiorespiratory fitness have a lower risk of mortality from all causes, as well as from coronary heart disease and cardiovascular disease, compared to their counterparts with inferior cardiorespiratory fitness, according to a study published in the May 20 issue of JAMA.

Abstract
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Benefits Seen in Myocardial Bone Marrow Cell Injections

TUESDAY, May 19 (HealthDay News) -- Injections of bone marrow cells into the myocardium of patients with chronic myocardial ischemia were associated with improved myocardial perfusion and left ventricular function, according to research published in the May 20 issue of JAMA.

Abstract
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Coronary Artery Bypass Care Quality Not Tied to Quantity

TUESDAY, May 19 (HealthDay News) -- Adherence to quality measures in coronary artery bypass follow-up care results in similar mortality rates whether the procedure is performed at a high-volume or low-volume cardiac care center, according to a study reported in the May 19 issue of the Annals of Internal Medicine.

Abstract
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Editorial (subscription or payment may be required)

'Obesity Paradox' Makes Heart Disease Outlook Puzzling

TUESDAY, May 19 (HealthDay News) -- Although obesity is associated with poor cardiovascular health, an "obesity paradox" shows that obese individuals with certain cardiovascular diseases or risk factors may have a better prognosis than people with a healthy weight, according to a review published in the May 26 issue of the Journal of the American College of Cardiology.

Abstract
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Higher Bleed Risk in Women With Acute Coronary Syndrome

MONDAY, May 18 (HealthDay News) -- Women with acute coronary syndrome (ACS) gained similar protection against ischemic events with bivalirudin compared to heparin plus a glycoprotein IIb/IIIa inhibitor (GPI), with less bleeding, according to research published in the May 1 issue of the American Journal of Cardiology.

Abstract
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Iron Not Linked to Survival in Primary Myelofibrosis

MONDAY, May 18 (HealthDay News) -- Higher serum ferritin levels weren't associated with decreased survival in patients with primary myelofibrosis, which could be a finding that's relevant to ongoing discussions in hematology regarding the use of iron chelation, according to research published in the May issue of the American Journal of Hematology.

Abstract
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Commentary

Common Viral Infection Increases Blood Pressure

FRIDAY, May 15 (HealthDay News) -- Infection with cytomegalovirus (CMV), found in more than 60 percent of adults, increases blood pressure, possibly through the renin-angiotensin system, according to a study published online May 15 in PLoS Pathogens.

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Imaging Technology Assesses Graft During Off-Pump CABG

FRIDAY, May 15 (HealthDay News) -- Intraoperative fluorescence imaging (IFI) can evaluate graft patency during off-pump coronary artery bypass graft (CABG) surgery, making possible immediate graft revision, if needed, and potentially better clinical outcomes, according to a study in the May issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

Abstract
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Editorial (subscription or payment may be required)

Maintaining Airway Pressure Benefits Post-Op Patients

FRIDAY, May 15 (HealthDay News) -- Maintaining positive airway pressure in patients after cardiac surgery can improve arterial oxygenation and reduce pulmonary complications, according to a study published in the May issue of Chest.

Abstract
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Smokers' Lower Body Weight Linked to Airway Gene

FRIDAY, May 15 (HealthDay News) -- The lower body weight in chronic smokers compared to nonsmokers may be caused by the increased expression of a gene in the airways that stimulates fat depletion, according to a study in the May issue of Chest.

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Patient Selection Crucial for Transcatheter AVR

THURSDAY, May 14 (HealthDay News) -- Transcatheter aortic valve replacement (AVR) is becoming an increasingly used option for patients with symptomatic aortic stenosis who aren't good candidates for surgical valve replacement, according to an overview published in the May 19 issue of the Journal of the American College of Cardiology.

Abstract
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Statins Slow Disease in Rheumatic Heart Disease

THURSDAY, May 14 (HealthDay News) -- Patients with rheumatic aortic valve stenosis have a slower rate of disease progression if they take statins, according to a study in the May 19 issue of the Journal of the American College of Cardiology.

Abstract
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Editorial (subscription or payment may be required)

More Exercise May Provide Greater Gains in Heart Disease

THURSDAY, May 14 (HealthDay News) -- A program featuring greater amounts of exercise and energy expenditure may be preferable to standard cardiac rehabilitation exercise in overweight patients with coronary heart disease, according to research published online May 11 in Circulation.

Abstract
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Cancer Caregivers Show Excessive Inflammation

WEDNESDAY, May 13 (HealthDay News) -- Caregivers of patients with brain cancer show increased inflammation in the year after diagnosis that could put them at risk of developing conditions involving excessive inflammation, according to a study published online May 11 in the Journal of Clinical Oncology.

Abstract
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Editorial

Diabetes Linked to Death After a Heart Attack

WEDNESDAY, May 13 (HealthDay News) -- Patients who have had a heart attack have a higher risk of death or hospitalization for heart failure if they have diabetes mellitus, according to a study in the May issue of JACC: Cardiovascular Imaging.

Abstract
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Editorial

Women Are Forgoing Health Care More Than Men

WEDNESDAY, May 13 (HealthDay News) -- Cost-related access problems disproportionately affect women, with 52 percent in 2007 reporting problems gaining access to the heath care they needed, compared with 39 percent of men, according to a report published May 11 by The Commonwealth Fund.

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Folate Fortification Law Linked to Decreased Heart Defects

WEDNESDAY, May 13 (HealthDay News) -- After a Canadian law mandating the fortification of flour and pasta products with folate went into effect in 1998, the birth prevalence of severe congenital defects has decreased in Quebec, according to a study published online May 12 in BMJ.

Abstract
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Editorial (subscription or payment may be required)

Role of Patent Foramen Ovale in Stroke Needs More Study

WEDNESDAY, May 13 (HealthDay News) -- Greater patient involvement in ongoing trials is needed to guide clinical decisions on the optimal treatment of patent foramen ovale (PFO) for stroke prevention, according to an advisory published online May 11 in Circulation.

Abstract
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Extreme Estradiol Levels Raise Heart Failure Death Risk

TUESDAY, May 12 (HealthDay News) -- Men with heart failure and moderate levels of serum estradiol are at lower risk of death than their counterparts with particularly high and low levels of the hormone, according to a study in the May 13 issue of the Journal of the American Medical Association.

Abstract
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Aspirin Benefit in Peripheral Artery Disease Examined

TUESDAY, May 12 (HealthDay News) -- Aspirin therapy does not appear to significantly reduce cardiovascular events in patients with peripheral artery disease (PAD), according to a study in the May 13 Journal of the American Medical Association.

Abstract
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Information Technology Helps With Blood Pressure Control

TUESDAY, May 12 (HealthDay News) -- An information technology-supported program helps hypertensive patients achieve blood pressure targets, according to a study published online May 5 in Circulation: Cardiovascular Quality and Outcomes.

Abstract
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Principles for Effectiveness Research Published

TUESDAY, May 12 (HealthDay News) -- Comparative effectiveness research is a useful approach to improving health care, but should focus on benefiting patients and not minimizing cost, according to a policy statement published online May 11 in Circulation.

Abstract
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Specific Diet May Reduce Risk of Heart Failure

TUESDAY, May 12 (HealthDay News) -- Middle-aged and older Swedish women who adhere to the Dietary Approaches to Stop Hypertension (DASH) diet are significantly less likely to develop heart failure, according to a study in the May 11 Archives of Internal Medicine.

Abstract
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Drug Promotional Items Affect Medical Students' Preference

TUESDAY, May 12 (HealthDay News) -- Medical students who are exposed to small branded promotional items from pharmaceutical companies may be more likely to hold favorable views of the advertised drug. However, the opposite effect may occur among students who attend schools with restrictive policies toward pharmaceutical marketing, according to a study published in the May 11 issue of the Archives of Internal Medicine.

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Kidney Disease Preventive Care Linked to Heart Protection

MONDAY, May 11 (HealthDay News) -- People with chronic kidney disease (CKD) who receive preventive care may have a lower risk of cardiovascular mortality and morbidity, according to research published online May 7 in the Journal of the American Society of Nephrology.

Abstract
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Polyunsaturated Fats Linked to Lower Levels of Inflammation

MONDAY, May 11 (HealthDay News) -- Long-chain omega-3 polyunsaturated fatty acids (PUFAs) from seafood were associated with lower levels of biomarkers of inflammation and endothelial activation, according to research published in the May 1 issue of the American Journal of Cardiology.

Abstract
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Patient Perception Key Factor for Depression in Heart Failure

MONDAY, May 11 (HealthDay News) -- Depression in heart failure patients appears to be more related to patients' perceptions of disease severity than objective measurements of severity, according to research published in the May 1 issue of the American Journal of Cardiology.

Abstract
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Genetic Variants Linked to Blood Pressure

MONDAY, May 11 (HealthDay News) -- Two genome-wide scans have identified loci associated with high blood pressure, according to two studies published online May 10 in Nature Genetics.

Abstract - Levy
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Abstract - Newton-Cheh
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Learning to Read CT Angiograms a Lengthy Process

MONDAY, May 11 (HealthDay News) -- Developing skill in reading coronary computed tomographic (CT) angiograms is a slow process and may require more training and practice than provided in a typical one-year fellowship, according to a study reported in the May issue of Radiology.

Abstract
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PAD Frequently Undiagnosed in Heart Disease Patients

FRIDAY, May 8 (HealthDay News) -- As many as one in six patients with coronary artery disease (CAD) may have overlooked peripheral arterial disease (PAD) despite specialist cardiovascular care, according to a study published in the May issue of Catheterization & Cardiovascular Interventions.

Abstract
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Death Rate After Ablation of Atrial Fibrillation 1 in 1,000

FRIDAY, May 8 (HealthDay News) -- While most patients with focal atrial tachycardia recover left ventricular function after catheter ablation, 1 in 1,000 patients with atrial fibrillation die, according to two studies in the May 12 issue of the Journal of the American College of Cardiology.

Abstract - Medi
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Abstract - Cappato
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Editorial (subscription or payment may be required)

Drug-Eluting Stents Beneficial for Off-Label Use

THURSDAY, May 7 (HealthDay News) -- Patients implanted with drug-eluting stents for off-label indications have lower rates of repeat target vessel revascularization and death without affecting the heart attack rate compared with bare-metal stents, according to a study in the May 12 issue of the Journal of the American College of Cardiology.

Abstract
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Correct Diagnosis of Syncope Important for Treatment

THURSDAY, May 7 (HealthDay News) -- Although difficult, correctly diagnosing the cause of syncope, a transient lack of consciousness followed by a quick recovery, is important in initiating effective treatment, according to a review in the May 12 issue of the Journal of the American College of Cardiology.

Abstract
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Drug-Eluting Stents May Help Prevent Restenosis

WEDNESDAY, May 6 (HealthDay News) -- Drug-eluting stents had lower rates of restenosis and lower rates of lesion and vessel revascularization in head-to-head trials against bare-metal stents in two studies published in the May 7 issue of the New England Journal of Medicine.

Abstract - Stone
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Abstract - James
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Visceral Fat-Depression Link Explored in Women

WEDNESDAY, May 6 (HealthDay News) -- Middle-aged women with depression tend to have more visceral fat than their nondepressed counterparts, which could explain why they are at higher risk for diabetes and cardiovascular disease, according to a study published online April 27 in Psychosomatic Medicine.

Abstract
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High Urine Albumin Linked to Venous Thromboembolism

TUESDAY, May 5 (HealthDay News) -- Already a recognized risk factor for arterial thromboembolism, microalbuminuria also is a risk factor for venous thromboembolism (VTE), according to a study published in the May 6 issue of the Journal of the American Medical Association.

Abstract
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Heart Arrhythmias Increase Mortality in Catheterizations

TUESDAY, May 5 (HealthDay News) -- The incidence of ventricular tachycardia or fibrillation (VT/VF) during and after percutaneous coronary intervention (PCI) is associated with higher death rates within 90 days, according to a study published in the May 6 issue of the Journal of the American Medical Association.

Abstract
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Medical Center Press Releases Often Lacking Key Details

TUESDAY, May 5 (HealthDay News) -- Press releases from academic medical centers may often overstate the importance of research findings while failing to acknowledge relevant limitations of the studies, according to research published in the May 5 Annals of Internal Medicine.

Full Text

Modified Protocol Improves Cardiac Arrest Survival

TUESDAY, May 5 (HealthDay News) -- Modified guidelines on the out-of-hospital management of cardiac arrest patients that optimizes compressions and reduces disruption improves survival rates, according to a study published online on May 4 in Circulation.

Abstract
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Genotype Linked to Cardiac Surgery Outcomes

TUESDAY, May 5 (HealthDay News) -- Patients who were homozygous for the low activity catechol-O-methyltransferase (COMT) L allele had a higher risk of vasodilatory shock and acute kidney injury following cardiac surgery with cardiopulmonary bypass, according to research published online April 30 in the Journal of the American Society of Nephrology.

Abstract
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Income, Education Associated With Diet Cost and Quality

MONDAY, May 4 (HealthDay News) -- People with higher socioeconomic status and educational levels are more likely to consume a costly but high-quality diet of lower-energy-density foods, according to a study published in the May issue of the Journal of the American Dietetic Association.

Abstract
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Wine Linked to Five-Year Bump in Men's Life Expectancy

MONDAY, May 4 (HealthDay News) -- Drinking wine may be associated with lower risk of cardiovascular-related death, according to research published online April 30 in the Journal of Epidemiology and Community Health.

Abstract
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Chemical Explains Problems After External Circulation

MONDAY, May 4 (HealthDay News) -- Cyclohexanone, a compound used to make intravenous bags and extracorporeal circulation equipment, can leach into the contained fluids and cause cardiovascular morbidities similar to those observed after extracorporeal circulation, according to a study published in the May issue of the American Journal of Physiology - Heart and Circulatory Physiology.

Abstract
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Recommended Drug Therapy Low in A-Fib, Heart Failure

FRIDAY, May 1 (HealthDay News) -- Patients with atrial fibrillation and heart failure may be undertreated, and such patients have a higher mortality risk than those with only atrial fibrillation, according to research published in the May 5 issue of the Journal of the American College of Cardiology.

Abstract
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More Americans Reporting Disability

FRIDAY, May 1 (HealthDay News) -- The number of Americans reporting disabilities rose by 7.7 percent from 44.1 million in 1999 to 47.5 million in 2005, according to a report in the May 1 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Drug-Eluting Stents Stack Up Well Against Bare-Metal Stents

FRIDAY, May 1 (HealthDay News) -- The use of drug-eluting stents (DES) appears safe and efficacious compared to bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI), according to research published in the May 5 issue of the Journal of the American College of Cardiology.

Abstract
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