December 2015 Briefing - Cardiology

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Here are what the editors at HealthDay consider to be the most important developments in Cardiology for December 2015. 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.

AMA: Burnout Is Top Issue for Physicians in 2015

WEDNESDAY, Dec. 30, 2015 (HealthDay News) -- Physician burnout is the top issue for physicians in 2015, according to a report published by the American Medical Association (AMA).

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Regional System of Care May Improve Outcomes for TAVR

WEDNESDAY, Dec. 30, 2015 (HealthDay News) -- A regional system of care seems beneficial for patients undergoing transcatheter aortic valve replacement (TAVR), according to a study published in the Dec. 28 issue of JACC: Cardiovascular Interventions.

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Optimism May Improve Outcomes Post Acute Coronary Syndrome

TUESDAY, Dec. 29, 2015 (HealthDay News) -- Post-acute coronary syndrome (ACS) optimism is associated with greater physical activity and lower rates of cardiac readmission at six months, according to a study published online Dec. 8 in Circulation: Cardiovascular Quality and Outcomes.

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Sodium Restriction May Be Detrimental in Heart Failure

TUESDAY, Dec. 29, 2015 (HealthDay News) -- Sodium restriction may be harmful in patients with chronic heart failure, according to a study published in the Jan. 1 issue of JACC: Heart Failure.

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History of CABG Linked to Reperfusion Delays in STEMI

MONDAY, Dec. 28, 2015 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), those with a history of coronary artery bypass graft surgery (CABG) are more likely to have reperfusion delays, according to a study published in the Dec. 28 issue of JACC: Cardiovascular Interventions.

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Higher Hospital Prices in U.S. 'Monopoly Markets'

MONDAY, Dec. 28, 2015 (HealthDay News) -- Prices at hospitals in monopoly markets are 15 percent higher than those at hospitals in areas with at least four providers, according to research published recently at the Health Care Pricing Project website.

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Treating Hypertension Beneficial Regardless of Baseline Pressure

MONDAY, Dec. 28, 2015 (HealthDay News) -- Blood pressure lowering treatment reduces the risk of major cardiovascular disease events, with reductions seen regardless of starting blood pressure, according to research published online Dec. 23 in The Lancet.

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Selexipag Linked to Reduced Risk of Death, Complications in PAH

WEDNESDAY, Dec. 23, 2015 (HealthDay News) -- For patients with pulmonary arterial hypertension, selexipag is associated with a reduced risk of a composite end point of death or pulmonary arterial hypertension-related complications, according to a study published in the Dec. 24 issue of the New England Journal of Medicine.

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Daily INR Measurement Best for Hospitalized Patients on Warfarin

WEDNESDAY, Dec. 23, 2015 (HealthDay News) -- For hospitalized patients, international normalized ratio (INR) monitoring less frequently than daily is associated with increased odds of warfarin-associated adverse events, according to a study published online Dec. 14 in the Journal of Hospital Medicine.

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Both Smoking Bans and Cigarette Taxes Deter Smokers

WEDNESDAY, Dec. 23, 2015 (HealthDay News) -- Comprehensive cigarette bans are most effective at limiting smoking among casual users, but high taxes may have the most impact on people who smoke more than a pack a day, according to a study published online Dec. 21 in the American Journal of Public Health.

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Ivabradine Improves Angina-Related Quality of Life

WEDNESDAY, Dec. 23, 2015 (HealthDay News) -- For patients with angina pectoris, ivabradine is associated with improvements in certain parameters of quality of life (QoL), according to a study published online Dec. 22 in Circulation: Cardiovascular Quality and Outcomes.

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Increase in Use of Mechanical Circulatory Support in PCI

WEDNESDAY, Dec. 23, 2015 (HealthDay News) -- For patients undergoing percutaneous coronary intervention (PCI) there has been an increase in use of mechanical circulatory support (MCS), according to a study published in the Jan. 1 issue of The American Journal of Cardiology.

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FDA Approves Uptravi for Pulmonary Arterial Hypertension

TUESDAY, Dec. 22, 2015 (HealthDay News) -- Uptravi (selexipag) has been approved by the U.S. Food and Drug Administration to treat adults with pulmonary arterial hypertension.

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Specific, Consistent ICD-10 Coding Key to Timely Payments

TUESDAY, Dec. 22, 2015 (HealthDay News) -- In order to prevent denials, it is important to code correctly within the International Classification of Diseases, Tenth Revision (ICD-10), with specificity matching documentation, according to an article published in Medical Economics.

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Many Ignore Warning Symptoms Before Sudden Cardiac Arrest

TUESDAY, Dec. 22, 2015 (HealthDay News) -- Patients with sudden cardiac arrest (SCA) frequently have warning symptoms, usually chest pain and dyspnea, in the month prior to the event, according to a study published online Dec. 22 in the Annals of Internal Medicine.

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Two Draft Statements From USPSTF Open for Comment

TUESDAY, Dec. 22, 2015 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) has found that current evidence is insufficient for determining the balance of benefits and harms of lipid disorder screening in children, while for statin use in adults, recommendations vary with patient age. These findings form the basis of two draft recommendation statements published online Dec. 21 by the USPSTF.

Draft Recommendation Statement - Lipid Screen
Evidence Review
Comment on Recommendations
Draft Recommendation Statement - Statin Use
Evidence Review
Comment on Recommendations

Affordable Care Act Has Improved Access to Care, Affordability

MONDAY, Dec. 21, 2015 (HealthDay News) -- Implementation of the Affordable Care Act has improved access to care and affordability of care for many adults, according to a study published in the December issue of Health Affairs.

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Pepducin PZ-128 Inhibits Platelet Protease-Activated Receptor-1

FRIDAY, Dec. 18, 2015 (HealthDay News) -- The pepducin PZ-128 offers rapid, specific, dose-dependent, and reversible inhibition of platelet protease-activated receptor-1, according to a study published online Dec. 17 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Nursing Conditions Tied to Hospital Cardiac Arrest Survival

FRIDAY, Dec. 18, 2015 (HealthDay News) -- Better work environments and decreased patient-to-nurse ratios on medical-surgical units are associated with higher odds of patient survival after an in-hospital cardiac arrest (IHCA), according to a study published in the January issue of Medical Care.

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FDA Approves LifeVest Wearable Defibrillator for Children

THURSDAY, Dec. 17, 2015 (HealthDay News) -- The LifeVest wearable defibrillator has been approved by the U.S. Food and Drug Administration for children at risk for cardiac arrest who can't have a defibrillator implanted. The device is already approved for adults.

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Effect of Availability of TAVR on Clinical Practice Evaluated

THURSDAY, Dec. 17, 2015 (HealthDay News) -- The use of transcatheter aortic-valve replacement (TAVR) increased in Germany from 2007 to 2013, with a moderate concomitant reduction in surgical aortic-valve replacement, according to a study published in the Dec. 17 issue of the New England Journal of Medicine.

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Industry Outpacing NIH in Funding Research

WEDNESDAY, Dec. 16, 2015 (HealthDay News) -- There's been a sharp rise in the number of industry-funded clinical trials and a significant decline in those financed by the U.S. government in recent years, according to findings published in the Dec. 15 issue of the Journal of the American Medical Association.

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Risk of CV Events Up After Shingles Diagnosis in Seniors

WEDNESDAY, Dec. 16, 2015 (HealthDay News) -- Stroke risk appears to more than double in the first week following a shingles diagnosis, with myocardial infarction (MI) risk also climbing, though not by quite as much, according to research published online Dec. 15 in PLOS Medicine.

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No Lasting Benefit for Early Tx of Patent Ductus Arteriosus

WEDNESDAY, Dec. 16, 2015 (HealthDay News) -- Early treatment to induce closure of the patent ductus arteriosus (PDA) in preterm infants does not improve long-term outcomes, according to a clinical report published online Dec. 15 in Pediatrics.

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Interaction Described Between Acenocoumarol, Levofloxacin

MONDAY, Dec. 14, 2015 (HealthDay News) -- More frequent monitoring may be required when patients are taking both acenocoumarol and levofloxacin due to the possibility of an adverse interaction, according to a case report published in the December issue of the Journal of Clinical Pharmacy and Therapeutics.

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New Model of Inpatient Care Can Improve Outcomes

MONDAY, Dec. 14, 2015 (HealthDay News) -- Implementation of a new model of care can improve outcomes of care in medical and surgical units, according to a study published in the December issue of the Journal of Hospital Medicine.

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Seven Behaviors Suggested to Improve 'Art of Medicine'

FRIDAY, Dec. 11, 2015 (HealthDay News) -- Seven behaviors should be implemented to improve the art of medicine, which can help improve relationships with patients, according to an article published in Family Practice Management.

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Central Venous Pressure-Guided Hydration Beneficial in CKD, CHF

FRIDAY, Dec. 11, 2015 (HealthDay News) -- For patients with chronic kidney disease (CKD) and congestive heart failure (CHF) undergoing coronary procedures, central venous pressure (CVP)-guided hydration is associated with reduced risk of contrast-induced nephropathy (CIN), according to a study published online Dec. 9 in JACC: Cardiovascular Interventions.

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Nutraceuticals Alone or With Ezetimibe Aid in Dyslipidemia

THURSDAY, Dec. 10, 2015 (HealthDay News) -- For statin-intolerant patients with dyslipidemia with ischemic heart disease treated with percutaneous coronary intervention, nutraceuticals alone or in combination with ezetimibe improve the lipid profile, according to a study published in the Dec. 15 issue of The American Journal of Cardiology.

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Nitrates in Heart Failure May Harm More Than Help

THURSDAY, Dec. 10, 2015 (HealthDay News) -- Nitrates don't improve quality of life or everyday activity levels as intended in patients with heart failure, according to research published in the Dec. 10 issue of the New England Journal of Medicine.

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Percentage of Graduates Entering GME Stable Over Past Decade

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- Despite an increase in the number of U.S. medical school graduates, over the past decade the percentage entering graduate medical education (GME) training has remained stable, according to a research letter published in the Dec. 8 issue of the Journal of the American Medical Association, a theme issue on medical education.

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Pediatric Allergic Disease May Up Cardiovascular Risk

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- Children with allergic disease may face as much as a doubling of their risk of hypertension and hyperlipidemia -- even if they aren't overweight, according to a letter to the editor published online Dec. 8 in the Journal of Allergy & Clinical Immunology.

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Warfarin + Sulfonylureas May Increase Risk of Hospitalization

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- Taking warfarin at the same time as glipizide or glimepiride may increase the risk of hospitalization, according to a study published online Dec. 7 in The BMJ.

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Depression Not Uncommon Among Resident Physicians

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- More than one in four doctors-in-training may be depressed, which could put their patients at risk, according to a study published in the Dec. 8 issue of the Journal of the American Medical Association, a theme issue on medical education.

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Guidelines Formulated for Arterial Conduits in CABG

WEDNESDAY, Dec. 9, 2015 (HealthDay News) -- Guidelines have been formulated for arterial conduits for coronary artery bypass graft (CABG) surgery, and published online Dec. 8 in the Annals of Thoracic Surgery.

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Med Ed Can Be Improved for High-Value, Cost-Conscious Care

TUESDAY, Dec. 8, 2015 (HealthDay News) -- The combination of effective transmission of knowledge, facilitation of reflective practice, and a supportive environment can educate physicians to deliver high-value, cost-conscious care, according to a review published in the Dec. 8 issue of the Journal of the American Medical Association, a theme issue on medical education.

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FDA Approves Kanuma for Lysosomal Acid Lipase Deficiency

TUESDAY, Dec. 8, 2015 (HealthDay News) -- Kanuma (sebelipase alfa) has been approved by the U.S. Food and Drug Administration as the first treatment for LAL deficiency (Wolman disease or cholesteryl ester storage disease).

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CDC: Fewer Americans Struggling With Medical Bills

TUESDAY, Dec. 8, 2015 (HealthDay News) -- Fewer American families are struggling to pay medical bills, according to a report from the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Review Compares Outcomes, Safety for Once-Weekly GLP-1RAs

TUESDAY, Dec. 8, 2015 (HealthDay News) -- Cardiometabolic outcomes and safety vary among different once-weekly glucagon-like peptide-1 receptor agonist (GLP-1RA) treatments, according to a review published online Dec. 8 in the Annals of Internal Medicine.

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U.S. Health Care Spending Increased in 2014

TUESDAY, Dec. 8, 2015 (HealthDay News) -- The expansion of insurance coverage and increases in retail prescription drug spending contributed to an increase in total national health care expenditures in 2014, according to a report published online Dec. 2 in Health Affairs.

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AAP: Screen All Children for Cholesterol, Depression, HIV

MONDAY, Dec. 7, 2015 (HealthDay News) -- All children should be screened for high cholesterol, depression, and HIV, with some tests starting as early as age 9, according to new guidelines from the American Academy of Pediatrics published online Dec. 7 in Pediatrics.

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Endurance Athletes May Suffer Dangerous Metabolic Effects

MONDAY, Dec. 7, 2015 (HealthDay News) -- Participation in the endurance competition known as the Ultraman is associated with dramatic alterations in body composition, muscle health, hormones, and metabolism, according to a study published online Nov. 11 in the European Journal of Applied Physiology.

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Statin Treatment Linked to Reduced Risk of Cataracts

MONDAY, Dec. 7, 2015 (HealthDay News) -- Statin treatment is associated with reduced risk of incident cataract development, according to a study published in the Dec. 15 issue of The American Journal of Cardiology.

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Cardiovascular Trial Sponsorship Significantly Impacts Findings

FRIDAY, Dec. 4, 2015 (HealthDay News) -- Large clinical studies that are sponsored by industry are more likely to report favorable outcomes and less likely to report unfavorable outcomes than those sponsored by the National Institutes of Health (NIH), particularly those in the cardiovascular field, according to research published in the Dec. 15 issue of The American Journal of Cardiology.

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Poor PCI Outcomes Up for Very Old With STEMI

FRIDAY, Dec. 4, 2015 (HealthDay News) -- Very old patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) have increased rates of PCI failure, bleeding complications, and mortality, but successful PCI still benefits mortality risk across all age groups, according to a study published in the Dec. 15 issue of The American Journal of Cardiology.

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Mechanical Thrombectomy Benefits Large Vessel Occlusion

FRIDAY, Dec. 4, 2015 (HealthDay News) -- For patients with acute ischemic stroke caused by large artery occlusion, mechanical thrombectomy after usual care is associated with improved outcomes versus usual care alone, according to a review published in the Dec. 8 issue of the Journal of the American College of Cardiology.

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CDC: Too Few Taking Needed Cholesterol-Lowering Drugs

FRIDAY, Dec. 4, 2015 (HealthDay News) -- Nearly half of American adults who should be taking cholesterol-lowering drugs don't, according to research published in the Dec. 4 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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AMA: Case Before Supreme Court Threatens Patient Privacy

THURSDAY, Dec. 3, 2015 (HealthDay News) -- A case before the Supreme Court is potentially threatening patient confidentiality, according to the American Medical Association (AMA).

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Plasma Prekallikrein May Be Vascular Risk Factor in T1DM

THURSDAY, Dec. 3, 2015 (HealthDay News) -- Plasma prekallikrein (PK) is associated with vascular disease risk in type 1 diabetes, according to a study published online Nov. 24 in Diabetes.

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IV Diuretics Deemed Safe in Outpatient Heart Failure Care

THURSDAY, Dec. 3, 2015 (HealthDay News) -- Intravenous (IV) diuretics appear to be safe and effective for outpatient volume management in heart failure, according to a study published online Dec. 2 in JACC: Heart Failure.

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Lixisenatide Doesn't Affect Cardiovascular Risk in T2DM

THURSDAY, Dec. 3, 2015 (HealthDay News) -- The addition of lixisenatide to usual care does not impact the rate of major cardiovascular events or other serious adverse events among patients with type 2 diabetes and a recent acute coronary syndrome, according to a study published in the Dec. 3 issue of the New England Journal of Medicine.

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CPAP, Mandibular Advancement Devices Both Help Lower BP

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- Continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) each produce a modest reduction in both systolic and diastolic blood pressure rates in patients with obstructive sleep apnea, according to a meta-analysis published in the Dec. 1 issue of the Journal of the American Medical Association.

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Burnout Rates on the Rise for Physicians

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- Burnout is a growing problem among American doctors, according to research published in the December issue of the Mayo Clinic Proceedings.

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Transfusion, Mortality Link Varies With Hemoglobin Levels

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- For critically ill patients, the impact of transfusion on mortality varies with hemoglobin (Hgb) levels and with the presence of comorbid heart disease, according to a study published in the Dec. 8 issue of the Journal of the American College of Cardiology.

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Endurance Exercise Accelerates Pathology With Gene Mutation

TUESDAY, Dec. 1, 2015 (HealthDay News) -- Endurance exercise seems to accelerate arrhythmogenic ventricular cardiomyopathy (AVC) pathogenesis in transgenic mice with the desmoplakin R2834H mutation (Tg-DSPR2834H), according to an experimental study published online Nov. 6 in the American Journal of Physiology: Heart and Circulatory Physiology.

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CDC: Cholesterol Levels Improving But More Work Needed

TUESDAY, Dec. 1, 2015 (HealthDay News) -- About one in every eight American adults continue to have high levels of total cholesterol, while even more have low levels of high-density lipoprotein (HDL) cholesterol, according to a December data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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