April 2016 Briefing - Cardiology

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Here are what the editors at HealthDay consider to be the most important developments in Cardiology for April 2016. 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.

Generic Crestor Approved by FDA

FRIDAY, April 29, 2016 (HealthDay News) -- The first generic version of Crestor (rosuvastatin calcium) tablets was approved Friday by the U.S. Food and Drug Administration.

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Wide Variation in Health Care Costs Across the U.S.

FRIDAY, April 29, 2016 (HealthDay News) -- Health care prices vary widely across the United States, even within the same state, according to a study published in the April issue of Health Affairs.

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Diagnostic Yield of Brugada Syndrome Up With Modified Leads

FRIDAY, April 29, 2016 (HealthDay News) -- Use of V1 and V2 leads recorded in the second and third intercostal spaces (High-ICS) increases the diagnostic yield for Brugada syndrome (BrS), according to a study published online April 21 in the Journal of Cardiovascular Electrophysiology.

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Article Discusses Workplace Violence in Health Care

THURSDAY, April 28, 2016 (HealthDay News) -- There is a lack of data relating to the prevalence of workplace violence in health care and how to address it, according to a review article published in the April 28 issue of the New England Journal of Medicine.

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Similar Outcome for Drug-Coated Balloon in Infrapopliteal Therapy

THURSDAY, April 28, 2016 (HealthDay News) -- For infrapopliteal arteries, revascularization therapy with drug-coated balloon (DCB) is associated with similar clinical outcomes as uncoated balloon or drug-eluting stent, according to a review and meta-analysis published online April 27 in JACC: Cardiovascular Interventions.

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U.S. Health Report Card Finds Racial, Ethnic Disparities Persist

WEDNESDAY, April 27, 2016 (HealthDay News) -- An update on Americans' health finds that racial and ethnic disparities persist, with significant gaps in obesity, cesarean births, and dental care. But advances have been made in some important areas, including infant mortality rates, women smokers, and numbers of uninsured, according to the new report from the U.S. Department of Health and Human Services.

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Doctors Have a Only a Few Weeks Left to Review Financial Data

WEDNESDAY, April 27, 2016 (HealthDay News) -- Under the Physician Payments Sunshine Act, physicians have only a few weeks left to review and report disputes relating to their financial ties to drug and medical device manufacturers, according to the American Medical Association.

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New Research Questions Link Between Statin Use and CRC Risk

WEDNESDAY, April 27, 2016 (HealthDay News) -- Long-term use of statins does not appear to reduce the risk of colorectal cancer (CRC), but a patient's cholesterol levels might affect risk, according to a study published online April 26 in PLOS Medicine.

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Six-Minute Walk Test Predicts Mortality in TMVR Patients

WEDNESDAY, April 27, 2016 (HealthDay News) -- For patients undergoing transcatheter mitral valve repair (TMVR), the six-minute walk test (6MWT) is independently associated with mortality, according to a research letter published in the May 3 issue of the Journal of the American College of Cardiology.

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Severe Childhood Obesity Still on the Rise in the United States

TUESDAY, April 26, 2016 (HealthDay News) -- Examining national data from 1999 through 2014, researchers found that one-third of American children aged 2 to 19 were overweight, nearly one-quarter were obese, and more than 2 percent were severely obese. The report was published online April 25 in Obesity.

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Coronary Heart Disease Risk Up for Women Working Night Shifts

TUESDAY, April 26, 2016 (HealthDay News) -- Women who work rotating night shifts may face a slightly increased risk of coronary heart disease (CHD), according to a report published in the April 26 issue of the Journal of the American Medical Association.

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Pharmacists Can Manage Some Chronic Conditions Effectively

TUESDAY, April 26, 2016 (HealthDay News) -- Pharmacists can do an effective job helping chronically ill patients manage their blood pressure, cholesterol, and blood glucose levels if they're allowed to direct patients' health care, according to an evidence review published online April 26 in the Annals of Internal Medicine.

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Prevalence of Migraine Up in Patients With Cardiac Syndrome X

TUESDAY, April 26, 2016 (HealthDay News) -- The prevalence of migraine headache is elevated in patients with cardiac syndrome X (CSX) compared to patients with coronary artery disease or healthy controls, according to a research letter published in the May 3 issue of the Journal of the American College of Cardiology.

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Saxagliptin, Sitagliptin Don't Up Hospitalized Heart Failure

TUESDAY, April 26, 2016 (HealthDay News) -- Use of saxagliptin or sitagliptin is not associated with increased risk of hospitalized heart failure (hHF) compared with other antihyperglycemic agents, according to a study published online April 26 in the Annals of Internal Medicine.

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A Doctor's View: EHRs Impair Physician-Patient Relationship

MONDAY, April 25, 2016 (HealthDay News) -- Electronic health records (EHRs) may be impairing the physician-patient relationship, according to an article published in Medical Economics.

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Physicians Can Get Involved in Developing Payment Models

FRIDAY, April 22, 2016 (HealthDay News) -- Doctors can be involved in developing new payment models for their practices, according to the American Medical Association.

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Lipid Tx Cuts Cardiovascular Risk with Type 1 Diabetes

FRIDAY, April 22, 2016 (HealthDay News) -- The risk of cardiovascular disease (CVD) and cardiovascular death is 22 to 44 percent lower among individuals with type 1 diabetes treated with lipid-lowering therapy (LLT), according to a study published online April 18 in Diabetes Care.

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How One Health System Is Shifting From Volume to Value

FRIDAY, April 22, 2016 (HealthDay News) -- ACCESS Health System, which operates 36 health centers, is transitioning to a patient-centered, physician-friendly health system that provides a continuum of care to underserved populations, according to the American Medical Association (AMA).

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Ideal BP in Elderly With Chronic Kidney Disease Unclear

FRIDAY, April 22, 2016 (HealthDay News) -- Age modifies the association between blood pressure (BP) and adverse cardiovascular and renal outcomes in elderly patients with chronic kidney disease (CKD), according to research published online April 21 in the Clinical Journal of the American Society of Nephrology.

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Aromatase Inhibitors Won't Raise Odds of Most Fatal CVD Events

FRIDAY, April 22, 2016 (HealthDay News) -- Treatment with aromatase inhibitors doesn't raise the risk of the most fatal cardiovascular disease events among breast cancer survivors, according to research published online April 21 in JAMA Oncology.

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Dietary Polyphenols Don't Provide Much CV Benefit in Metabolic Sx

FRIDAY, April 22, 2016 (HealthDay News) -- Supplementation with polyphenols does not strongly protect against cardiovascular diseases among patients with metabolic syndrome (MetS), according to a review published online April 15 in Obesity Reviews.

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Interrupting Prolonged Sitting Beneficial in Type 2 Diabetes

THURSDAY, April 21, 2016 (HealthDay News) -- For patients with type 2 diabetes (T2D), interrupting prolonged sitting with three-minute bouts of light-intensity walking (LW) or simple resistance activities (SRA) every 30 minutes improves postprandial cardiometabolic risk markers compared with uninterrupted sitting (SIT), according to a study published online April 13 in Diabetes Care.

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Do Antihistamines Blunt Exercise Recovery?

THURSDAY, April 21, 2016 (HealthDay News) -- Histamine may contribute to exercise recovery in skeletal muscle, and blockade of histamine receptors may interfere with that mechanism, according to research published online April 9 in the Journal of Physiology.

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No Solid Evidence for Pre-Participation Screens in Athletes

THURSDAY, April 21, 2016 (HealthDay News) -- There is no solid evidence for the effectiveness of pre-participation screening in reducing the number of sudden cardiac deaths among young athletes, according to an analysis published online April 20 in The BMJ.

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LDL Reduction in Hypertriglyceridemia Varies Per Statin

WEDNESDAY, April 20, 2016 (HealthDay News) -- For patients with hypertriglyceridemia, low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) reductions depend of the choice and dose of statin, according to research published in the May 1 issue of The American Journal of Cardiology.

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In Breast CA, Cardiotoxicity Up With Trastuzumab-Based Chemo

WEDNESDAY, April 20, 2016 (HealthDay News) -- For adult women with breast cancer, trastuzumab-based regimens are associated with increased risk of cardiotoxicity, according to a study published online April 18 in the Journal of Clinical Oncology.

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Better Functional Outcome With Stent Retrievers in Acute Stroke

WEDNESDAY, April 20, 2016 (HealthDay News) -- For patients with acute ischemic stroke, treatment with stent retrievers with quick reperfusion time is associated with improved outcomes, according to a study published online April 19 in Radiology.

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Lower CVD Mortality for Metformin Versus Sulfonylureas

TUESDAY, April 19, 2016 (HealthDay News) -- Metformin is associated with reduced cardiovascular mortality compared with sulfonylureas, according to a large analysis published online April 19 in the Annals of Internal Medicine.

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Mineralocorticoid Receptor Antagonists No Benefit Post MI

TUESDAY, April 19, 2016 (HealthDay News) -- For patients with post-myocardial infarction (MI) heart failure, mineralocorticoid receptor antagonists (MRAs) do not improve outcome, according to a study published in the April 26 issue of the Journal of the American College of Cardiology.

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Physicians May Be Ordering Carotid Imaging Too Often

MONDAY, April 18, 2016 (HealthDay News) -- Many heart patients undergo carotid imaging for uncertain or inappropriate reasons, according to a study published online April 18 in JAMA Internal Medicine.

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Article Offers Ways to Address Overlooked Details in Practice

MONDAY, April 18, 2016 (HealthDay News) -- Looking at a family medicine practice with fresh eyes can help address unsightly issues that patients notice, according to an article published in Family Practice Management.

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Single 3-Minute Freeze Beneficial in Paroxysmal A-Fib

MONDAY, April 18, 2016 (HealthDay News) -- For patients with paroxysmal atrial fibrillation (PAF) undergoing pulmonary vein isolation (PVI), a single 3-minute freezing approach is as effective as a conventional 4-minute approach plus bonus application using second-generation cryoballoon (CB-Adv), according to a study published online April 11 in the Journal of Cardiovascular Electrophysiology.

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Genetic Vitamin K1 Levels Linked to Heart Disease

MONDAY, April 18, 2016 (HealthDay News) -- Genetically determined vitamin K1 is associated with coronary artery disease (CAD) and myocardial infarction (MI), according to a study published online April 8 in the Journal of Thrombosis and Haemostasis.

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Antithrombotic Rx Could Be Optimized for Older A-Fib Patients

MONDAY, April 18, 2016 (HealthDay News) -- A considerable proportion of older patients with atrial fibrillation (AF) are not prescribed antithrombotics, according to a study published online April 7 in the Journal of Clinical Pharmacy and Therapeutics.

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No Racial Difference in Prognostic Value of Cardiorespiratory Fitness

FRIDAY, April 15, 2016 (HealthDay News) -- Cardiorespiratory fitness (CRF) predicts all-cause mortality, with no racial differences in its prognostic value, according to a study published in the May 1 issue of The American Journal of Cardiology.

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2016 Match Marks Record Highs for Registrants, Matching

FRIDAY, April 15, 2016 (HealthDay News) -- The 2016 Match was the largest ever recorded by the National Resident Matching Program, with a higher match rate that 2015, according to a report from the American Medical Association.

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Improved Functional Outcomes With Adoption of GWTG-Stroke

FRIDAY, April 14, 2016 (HealthDay News) -- Adoption of the Get With The Guidelines (GWTG)-Stroke program is associated with improved functional outcomes at discharge and reduced post-discharge mortality for Medicare beneficiaries with acute stroke, according to a study published online April 14 in Stroke.

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Decrease in Medicare Spending for 2012 ACO Entrants

FRIDAY, April 15, 2016 (HealthDay News) -- Early reductions in Medicare spending were seen for the first full year of Medicare Shared Savings Program (MSSP) contracts for 2012 Accountable Care Organization (ACO) entrants, according to a study published online April 13 in the New England Journal of Medicine.

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Abdominal Aortic Aneurysm Odds Up for Patients With Psoriasis

FRIDAY, April 15, 2016 (HealthDay News) -- Psoriasis patients may face a higher risk of an abdominal aortic aneurysm, according to a study published online April 14 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Health Care Workers Skip Hand Washing One-Third of the Time

THURSDAY, April 14, 2016 (HealthDay News) -- Staff at many outpatient health care facilities in New Mexico failed to follow recommendations for hand hygiene more than one-third of the time, according to findings published in the April 1 issue of the American Journal of Infection Control.

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Adding Number of Vessels With CAC Ups Prediction of CVD Events

THURSDAY, April 14, 2016 (HealthDay News) -- Inclusion of the number of vessels with coronary artery calcium (CAC) improves the capacity of the Agatston CAC score to predict cardiovascular events, according to a study published online April 13 in JACC: Cardiovascular Imaging.

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Bariatric Surgical Skill Doesn't Appear to Weigh on Outcomes

WEDNESDAY, April 13, 2016 (HealthDay News) -- Surgical skill does not appear to affect postoperative weight loss or resolution of medical conditions at one year after laparoscopic gastric bypass, according to a study published online April 13 in JAMA Surgery.

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Benefits of Polyunsaturated Over Saturated Fat Deemed Uncertain

WEDNESDAY, April 13, 2016 (HealthDay News) -- Controversial new research challenges the idea that heart health will improve if people cut saturated fat -- typically from animal sources -- from their diets in favor of vegetable oil. The findings were published online April 12 in The BMJ.

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Review: Low Risk of Birth Defects With Ondansetron Exposure

WEDNESDAY, April 13, 2016 (HealthDay News) -- The offspring of women using ondansetron early in pregnancy for nausea and vomiting of pregnancy or hyperemesis gravidarum may be at risk for cardiac abnormalities, although the overall risk of birth defects associated with exposure appears low, according to a review published in the May issue of Obstetrics & Gynecology.

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CV Risk Not Significantly Different for GLP-1 Receptor Agonists

TUESDAY, April 12, 2016 (HealthDay News) -- There are no significant differences in occurrence of cardiovascular disease (CVD) tied to treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA) compared with dipeptidyl peptidase-4 inhibitors (DPP-4i), second generation sulfonylureas, or insulin, in combination with metformin, according to a study published online March 22 in Diabetes, Obesity and Metabolism.

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Doctors Can Be Misled About FDA 'Breakthrough' Drug Designation

TUESDAY, April 12, 2016 (HealthDay News) -- Use of the word "breakthrough" in the U.S. Food and Drug Administration's expedited approval process could mislead doctors about the new drugs' actual benefits, according to a research letter published in the April 12 issue of the Journal of the American Medical Association.

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CCTA Tied to More Appropriate Use of Invasive Angiography

TUESDAY, April 12, 2016 (HealthDay News) -- Coronary computed tomography angiography (CCTA) is associated with more appropriate use of invasive angiography and increased use of preventive therapies, according to a study published online April 11 in the Journal of the American College of Cardiology.

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Review Addresses Chest Pain in Young Adults Presenting to ER

TUESDAY, April 12, 2016 (HealthDay News) -- For young adults presenting to the emergency department with acute chest pain, after ruling out cardiac risk, physicians should focus on stress reaction, according to a review published in the March issue of the Journal of Emergency Nursing.

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New-Onset A-Fib Post Acute MI Ups Complications, Readmission

TUESDAY, April 12, 2016 (HealthDay News) -- New-onset atrial fibrillation (AF) after acute myocardial infarction (AMI) is strongly tied to in-hospital complications and higher short-term readmission rates, according to a study published in the April 15 issue of The American Journal of Cardiology.

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Telomere Length Tied to Higher Myocardial Infarction Risk

MONDAY, April 11, 2016 (HealthDay News) -- Telomere length (TL) is associated with an increased risk of myocardial infarction (MI), according to a study published in the April 19 issue of the Journal of the American College of Cardiology.

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USPSTF: Aspirin Recommended for Some Aged 50 to 69 Years

MONDAY, April 11, 2016 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends aspirin use for primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in certain adults aged 50 to 69 years, but not in younger or older adults. These findings form the basis of a recommendation statement, published online April 11 in the Annals of Internal Medicine.

Recommendation Statement
Evidence Review 1 (subscription or payment may be required)
Evidence Review 2 (subscription or payment may be required)
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VA Commission on Care: Eliminate VA Medical Centers

MONDAY, April 11, 2016 (HealthDay News) -- A radical proposal has been suggested for eliminating all Veterans Affairs (VA) medical centers and outpatient facilities in the next 20 years, floated by seven of 15 members of the VA Commission on Care, according to an article published in the Military Times.

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Progesterone Attenuates Drug-Induced QT Interval Lengthening

MONDAY, April 11, 2016 (HealthDay News) -- For healthy females, oral progesterone administration attenuates drug-induced QT interval lengthening, according to a study published online April 6 in JACC: Clinical Electrophysiology.

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Niacin-ER May Be Overlooked Cause of Thrombocytopenia

FRIDAY, April 8, 2016 (HealthDay News) -- Extended-release (ER) niacin is associated with progressive and reversible thrombocytopenia, according to a letter to the editor published online March 25 in the American Journal of Hematology.

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ACEI/ARBs Up AMI Outcomes Regardless of Renal Status

FRIDAY, April 8, 2016 (HealthDay News) -- For acute myocardial infarction (AMI) survivors, angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) treatment is associated with improved long-term survival, according to research published in the April 12 issue of the Journal of the American College of Cardiology.

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FDA Approves First Leadless Pacemaker

THURSDAY, April 7, 2016 (HealthDay News) -- The first leadless, wire-free pacemaker to treat heart rhythm disorders has been approved by the U.S. Food and Drug Administration.

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Daily Fresh Fruit Intake May Improve Cardiovascular Health

THURSDAY, April 7, 2016 (HealthDay News) -- Eating fresh fruit regularly may help prevent heart attacks and strokes, according to a study published in the April 7 issue of the New England Journal of Medicine.

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Sacubitril-Valsartan May Be Cost-Effective Option in HFrEF

THURSDAY, April 7, 2016 (HealthDay News) -- For patients with heart failure with reduced ejection fraction (HFrEF), sacubitril-valsartan may be cost-effective, depending on the willingness-to-pay threshold, according to a study published online March 30 in JACC: Heart Failure.

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New Dietary Guidelines for Americans Issued for 2015-2020

THURSDAY, April 7, 2016 (HealthDay News) -- New U.S. dietary guidelines have been released for 2015 to 2020, according to a health policy brief published online March 31 in Health Affairs.

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Since 1980, Diabetes Cases Have Quadrupled Globally

WEDNESDAY, April 6, 2016 (HealthDay News) -- The number of adults worldwide with diabetes has quadrupled in the past 35 years, according to a report published online April 6 in The Lancet.

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Subclinical Cardiac Dysfunction Frequent in Hispanics/Latinos

WEDNESDAY, April 6, 2016 (HealthDay News) -- Hispanics/Latinos frequently have cardiac dysfunction, which is usually subclinical or unrecognized, according to a study published online April 5 in Circulation: Heart Failure.

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FDA Issues New Warning for Two Diabetes Medications

WEDNESDAY, April 6, 2016 (HealthDay News) -- Diabetes medications containing saxagliptin and alogliptin may raise the risk of heart failure, particularly in patients with heart or kidney disease, U.S. health officials warned Tuesday.

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Diuretic Dose Not Linked to Outcome in Heart Failure

WEDNESDAY, April 6, 2016 (HealthDay News) -- For patients with worsening heart failure, after adjustment for pre-specified covariates of disease severity, diuretic dose is not associated with mortality and heart failure rehospitalization, according to a study published online March 30 in JACC: Heart Failure.

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Intraarterial Chemo + Radiation May Up Cerebral Infarctions

MONDAY, April 4, 2016 (HealthDay News) -- Intraarterial chemoradiotherapy (CRT) for head and neck cancer is tied to a higher incidence of cerebral infarction, compared to intravenous CRT, according to a study published online March 25 in Head & Neck.

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Renal Function Key to Cardiac Outcome in Statin-Treated CHD

FRIDAY, April 1, 2016 (HealthDay News) -- For statin-treated patients with coronary heart disease (CHD), stabilization or improvement in renal function is associated with a reduced rate of major cardiovascular events (MCVEs), according to a study published in the April 15 issue of The American Journal of Cardiology.

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Are Guidelines Needed to Assess Competence of Aging Physicians?

FRIDAY, April 1, 2016 (HealthDay News) -- The question of whether national guidelines need to be developed for assessing the competence of aging physicians was discussed during a recent meeting of key stakeholders, according to a news release from the American Medical Association (AMA).

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Chances of Meeting 2025 Global Obesity Target Near Zero

FRIDAY, April 1, 2016 (HealthDay News) -- Since 1975, the mean body mass index (BMI) of men and women has increased and trends in obesity have been increasing worldwide, according to a study published in the April 2 issue of The Lancet.

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