American College of Cardiology, March 17-19

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The American College of Cardiology's 66th Annual Scientific Session & Expo

The annual meeting of the American College of Cardiology was held from March 17 to 19 in Washington, D.C., and attracted more than 20,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in cardiology. The conference highlighted recent advances in the treatment, management, and prevention of cardiovascular diseases, with presentations also focusing on novel drugs and surgical approaches to improve the quality of care for patients with cardiovascular diseases.

In one study, Mark Munger, Pharm.D., of the University of Utah College of Pharmacy in Salt Lake City, and colleagues found that veterans who took a combination of misoprostol and prescription nonsteroidal anti-inflammatory drugs (NSAIDs) for stomach ulcers had a significantly lower risk of serious cardiovascular, cerebrovascular, and renal events compared to individuals who only took prescribed NSAIDs.

"We evaluated approximately 1.6 million veterans over the course of the study," Munger said. "Patients needed to be on new prescription NSAIDs or misoprostol taken on a regular basis over a year time period. We compared veteran patients prescribed a NSAID alone to those prescribed an NSAID plus misoprostol."

After matching the two groups for 48 variables, the investigators found that in 1,875 matched patients taking either a NSAID alone or a NSAID plus misoprostol, the combination group had a significant 44 percent reduction in NSAID-induced cardiovascular events, 25 percent reduction in cerebrovascular events, and 34 percent reduction in renal events.

"This is the second study we completed evaluating the effects of the combination of NSAIDs plus misoprostol for reducing NSAID-induced cardio-renal events. We completed a smaller, pilot study of approximately 20 patients evaluating cardiac and renal hemodynamics with similar findings," Munger said. "Taking the results of the preliminary study combined with this large Veteran's Administration historical cohort study, the combination of NSAID plus misoprostol significantly reduced cardiovascular, cerebrovascular, and renal events, compared to taking NSAIDs alone."

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In another study, Charbel Abi Khalil, M.D., Ph.D., of Weill Cornell Medicine in New York City, and colleagues observed a reduction in long-term mortality in diabetes patients with a systolic blood pressure of greater than 150 mm Hg on discharge from hospitalization for acute heart failure; however, this benefit was counteracted by an increase in the risk of re-hospitalization for heart failure.

"The relation between blood pressure, acute heart failure, and diabetes has not been investigated yet. Previous reports suggest that the body mass index, a close cardiometabolic marker, is inversely correlated to mortality in patients with diabetes and heart failure, contrary to investigators' expectations of an increased mortality in overweight and obese patients, which led to the notion of 'obesity paradox.' Our results suggest that we could also be looking at a 'blood pressure paradox' if our findings meet with future similar studies," Abi Khalil said. "A high systolic blood pressure on discharge from acute heart failure is protective against mortality in patients with type 2 diabetes, at the price of increased hospitalization. However, only a randomized controlled study can confirm our findings and trigger the implementation of specific guidelines for patients with diabetes and heart failure."

The study was an analysis of the Gulf-CARE registry, which is conducted under the guidance of the Gulf Heart Association and funded by Servier.

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Yoav Arnson, M.D., of the Cedars-Sinai Medical Center in Los Angeles, and colleagues found that hormone replacement therapy (HRT) is associated with reduced mortality in postmenopausal women with no prior known heart disease.

The investigators found that postmenopausal women with no known prior heart disease or chest pain symptoms who take HRT have lower calcium scores in their coronary arteries. When following these women, in repeat scans, the researchers found that the women who did not take HRT had a faster progression of their coronary calcium.

"The women taking HRT had a lower mortality rate. These differences were significant after a multivariant analysis (0.7 times reduced mortality)," Arnson said. "I think it is too soon to significantly alter daily practice. The current practice is to prescribe HRT with postmenopausal symptoms and after five years to try to discontinue. I believe our findings support this practice. We expect more studies to come out and further characterize what groups of women will benefit the most from this treatment."

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ACC: Rivaroxaban Beats Aspirin for Lower Risk of Recurrent VTE

MONDAY, March 20, 2017 (HealthDay News) -- Rivaroxaban is associated with reduced risk of recurrent events among patients with venous thromboembolism in equipoise for continued anticoagulation, according to a study published online March 18 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American College of Cardiology, held from March 17 to 19 in Washington, D.C.

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ACC: Guidelines Differ on Statin Eligibility for African-Americans

MONDAY, March 20, 2017 (HealthDay News) -- Guidelines differ on recommendations for statin treatment in African-Americans, according to a study published online March 18 in JAMA Cardiology to coincide with the annual meeting of the American College of Cardiology, held from March 17 to 19 in Washington, D.C.

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ACC: Meds Targeting PCSK9 Show Benefit for High-Risk Patients

FRIDAY, March 17, 2017 (HealthDay News) -- Evolocumab and inclisiran, medications targeting proprotein convertase subtilisin-kexin type 9 (PCSK9), can benefit patients with atherosclerotic cardiovascular disease by lowering low-density lipoprotein (LDL) cholesterol levels below current targets, according to findings published online March 17 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American College of Cardiology, held from March 17 to 19 in Washington, D.C.

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ACC: Antithrombotic Benefit Found Lacking in Low-Risk A-Fib

FRIDAY, March 17, 2017 (HealthDay News) -- For some atrial fibrillation patients with low CHADS2 scores, antithrombotic therapy is associated with higher rates of stroke and significant bleeding, according to research presented at the annual meeting of the American College of Cardiology, held from March 17 to 19 in Washington, D.C.

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ACC: Exercise May Improve Prognosis of Hypertrophic CM

FRIDAY, March 17, 2017 (HealthDay News) -- For patients with hypertrophic cardiomyopathy, moderate-intensity exercise is associated with a small but statistically significant increase in exercise capacity at 16 weeks, according to a study published online March 18 in the Journal of the American Medical Association. The research was published to coincide with the annual meeting of the American College of Cardiology, held from March 17 to 19 in Washington, D.C.

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ACC: TAVR Noninferior to Surgery for Severe Aortic Stenosis

FRIDAY, March 17, 2017 (HealthDay News) -- For patients with severe aortic stenosis at intermediate surgical risk, transcatheter aortic-valve replacement (TAVR) is noninferior to surgery, according to a study published online March 17 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American College of Cardiology, held from March 17 to 19 in Washington, D.C.

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ACC: Erectile Dysfunction Drugs May Benefit Men's Hearts

FRIDAY, March 10, 2017 (HealthDay News) -- Phosphodiesterase type 5 (PDE5) inhibitors appear to reduce a man's risk of death or heart failure after a first myocardial infarction (MI), according to research being presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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ACC: Zika Linked to Negative Cardiovascular Effects in Adults

FRIDAY, March 10, 2017 (HealthDay News) -- Zika may have detrimental effects on the heart in some patients infected with the virus, according to research being presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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ACC: Cannabis Tied to Higher Odds for Stroke, Heart Failure

FRIDAY, March 10, 2017 (HealthDay News) -- Cannabis use may raise an adult's risk of stroke and heart failure, according to research being presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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ACC: Hospitalizations Up for Heart Failure Patients in Winter

THURSDAY, March 9, 2017 (HealthDay News) -- Winter is a particularly precarious time for heart failure patients, according to two studies being presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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ACC: Sodium Intake Rising Among Patients With HTN

THURSDAY, March 9, 2017 (HealthDay News) -- Americans with hypertension are getting more sodium in their diet than they did in 1999, according to research being presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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ACC: Younger MI Patients More Likely to Have Low HDL, High LDL

THURSDAY, March 9, 2017 (HealthDay News) -- Cholesterol's impact on myocardial infarction (MI) may differ by age, according to research being presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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ACC: Wrist Heart Rate Monitors Less Accurate Than Chest Strap

THURSDAY, March 9, 2017 (HealthDay News) -- Wrist-worn fitness devices may be less accurate than thought during certain exercises, according to research being presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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ACC: High Readmission Rate for Critical Limb Ischemia

TUESDAY, March 7, 2017 (HealthDay News) -- For patients with critical limb ischemia (CLI), readmission is high, with most readmissions unplanned, according to a study published online March 6 in the Journal of the American College of Cardiology. The research will also be presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, D.C.

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