June 2016 Briefing - Cardiology

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

End-of-Life Decision-Making Video Aids Heart Failure Patients

THURSDAY, June 30, 2016 (HealthDay News) -- Watching a video about end-of-life care options may help patients with advanced heart failure choose the approach best for them, according to a study published online June 29 in Circulation.

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Lisinopril Therapy Cuts Incident Conduction System Disease

THURSDAY, June 30, 2016 (HealthDay News) -- Lisinopril therapy is associated with a significant reduction in incident conduction system disease, according to a study published online June 27 in JAMA Internal Medicine.

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Butter May Not Be As Unhealthy As Previously Thought

THURSDAY, June 30, 2016 (HealthDay News) -- Butter may not be the unhealthy food many Americans believe it to be; however, that doesn't mean that butter provides any real health benefit, according to research published online June 29 in PLOS ONE.

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Cardiovascular Disease Mortality Progress Slowing Down in U.S.

WEDNESDAY, June 29, 2016 (HealthDay News) -- The rate of decline in cardiovascular disease mortality has decelerated, according to research published online June 29 in JAMA Cardiology.

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Electronic Record Demands Are Overwhelming Many Physicians

WEDNESDAY, June 29, 2016 (HealthDay News) -- Physicians using electronic practice tools report higher rates of burnout and increased frustration with the amount of computerized paperwork, according to research published online June 27 in the Mayo Clinic Proceedings.

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Genetic Heart Condition Common Cause of Sudden Death in Sports

WEDNESDAY, June 29, 2016 (HealthDay News) -- About one-third of sudden deaths are caused by hypertrophic cardiomyopathy, according to research published recently in The American Journal of Medicine.

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Escitalopram Not Beneficial for Heart Failure Patients

WEDNESDAY, June 29, 2016 (HealthDay News) -- The antidepressant escitalopram may not help heart failure patients suffering from depression, according to research published in the June 28 issue of the Journal of the American Medical Association.

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Too Many Elderly, Terminal Patients Getting Unnecessary Tx

TUESDAY, June 28, 2016 (HealthDay News) -- Patients dying in old age often receive unnecessary end-of-life medical treatments in hospitals, according to research published online June 27 in the International Journal for Quality in Health Care.

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Omega-3s Tied to Lower Risk of Fatal Coronary Heart Disease

TUESDAY, June 28, 2016 (HealthDay News) -- Regularly eating fish and other foods rich in omega-3 fatty acids may lower the risk of fatal coronary heart disease (CHD), according to a review published online June 27 in JAMA Internal Medicine.

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End-of-Life Care Received Varies Based on Type of Disease

TUESDAY, June 28, 2016 (HealthDay News) -- Family-reported quality of end-of-life care is significantly better for patients with cancer or dementia than for patients with other chronic conditions, according to research published online June 26 in JAMA Internal Medicine to coincide with presentation at AcademyHealth's Annual Research Meeting, held from June 26 to 28 in Boston.

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Clopidogrel Plus Aspirin Good for Noncarriers of CYP2C19 Variants

TUESDAY, June 28, 2016 (HealthDay News) -- For patients with minor ischemic stroke or transient ischemic attack, the risk of new stroke is reduced with use of clopidogrel plus aspirin versus aspirin alone among those who are not carriers of the CYP2C19 loss-of-function alleles, according to a study published online June 23 in the Journal of the American Medical Association. The research was published to coincide with the Second Annual Scientific Session of the Chinese Stroke Association and the Tiantan International Stroke Conference, held from June 24 to 26 in Beijing.

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Patients Face High Hospital Bills Despite Having Insurance

MONDAY, June 27, 2016 (HealthDay News) -- Costs of hospitalization for privately insured adults rose more than 37 percent over five years, with patients paying more than $1,000 on average by 2013, according to research published online June 27 in JAMA Internal Medicine.

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Many Teens Using Unregulated Supplements to Alter Appearance

MONDAY, June 27, 2016 (HealthDay News) -- Many teens are turning to risky, unregulated supplements to change their appearance, according to a new report from the American Academy of Pediatrics (AAP) published online June 27 in Pediatrics.

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ALT Levels Within Normal Range Linked to Cardiovascular Events

MONDAY, June 27, 2016 (HealthDay News) -- Alanine aminotransferase (ALT) levels within normal range are associated with cardiovascular event risk, according to a study published in the July 1 issue of The American Journal of Cardiology.

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Mortality Up With No Revascularization in NSTEMI

FRIDAY, June 24, 2016 (HealthDay News) -- Mortality is increased for patients with non-ST-segment elevation myocardial infarction (NSTEMI) who do not undergo coronary revascularization, according to a study published in the July 1 issue of The American Journal of Cardiology.

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Diabetes Increases Mortality Risk After Acute Myocardial Infarction

FRIDAY, June 24, 2016 (HealthDay News) -- Patients with diabetes are much more likely to die after an acute myocardial infarction (AMI) than patients without diabetes, according to a study published online June 15 in the Journal of Epidemiology and Community Health.

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2017 Will Bring Premium Rate Increases Under ACA

FRIDAY, June 24, 2016 (HealthDay News) -- Health insurance premiums under the Affordable Care Act will rise in 2017, analysts and insurance brokers say.

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Candesartan Doesn't Prevent Trastuzumab Cardiotoxicity

FRIDAY, June 24, 2016 (HealthDay News) -- In patients with early breast cancer, candesartan does not protect against trastuzumab-related cardiotoxic effects, according to a study published online June 23 in JAMA Oncology.

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Diabetes Plus Kidney Disease Raises CVD Risk in Blacks

FRIDAY, June 24, 2016 (HealthDay News) -- For black Americans with diabetes, chronic kidney disease (CKD) appears to increase the risk of cardiovascular mortality, according to a study published online June 23 in the Clinical Journal of the American Society of Nephrology.

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Digital Technology Holds Potential in Emergency CVD Care

THURSDAY, June 23, 2016 (HealthDay News) -- Smartphones, apps, and other digital technology could speed emergency care to patients experiencing an acute myocardial infarction (AMI), stroke, or cardiac arrest, according to a new report issued by the American Heart Association (AHA) and published online June 22 in Circulation.

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Genetic Testing Helps Identify Causes of Sudden Cardiac Death

THURSDAY, June 23, 2016 (HealthDay News) -- Genetic testing can increase the identification of a possible cause of sudden cardiac death in children and young adults, according to a study published in the June 23 issue of the New England Journal of Medicine.

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CDC: Alternative Medicine a Booming Business in U.S.

WEDNESDAY, June 22, 2016 (HealthDay News) -- Americans spent more than $30 billion out of pocket in 2012 on chiropractors and other complementary health practitioners, as well as supplements and other forms of alternative medicine, according to research published online June 22 in the U.S. Centers for Disease Control and Prevention's National Health Statistics Reports.

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Daily Steps in Children With T1DM Tied to Early Atherosclerosis

WEDNESDAY, June 22, 2016 (HealthDay News) -- For children with type 1 diabetes, the number of daily steps is associated with early signs of atherosclerosis and adverse cardiovascular risk, according to a study published online June 15 in Diabetes Care.

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Male PCPs Less Likely to Assess CVD Risk in Female Patients

WEDNESDAY, June 22, 2016 (HealthDay News) -- Many male primary care physicians regard cardiovascular disease as a man's issue and don't assess risk in female patients, according to research published online June 21 in the European Journal of Preventive Cardiology.

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Risk of Cardiovascular Events Up in Black Patients With A-Fib

WEDNESDAY, June 22, 2016 (HealthDay News) -- Black Americans with atrial fibrillation are at higher risk than whites for serious cardiovascular complications and death, according to a study published online June 22 in JAMA Cardiology.

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Dropping Troponin Test May Up Number of Donor Hearts Available

WEDNESDAY, June 22, 2016 (HealthDay News) -- The troponin I blood test that's used to check the health of a donor heart may not accurately predict if a heart transplant will be successful, according to a study published online June 21 in Circulation: Heart Failure.

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Statins Could Reduce Risk of Infection in Stroke Patients

WEDNESDAY, June 22, 2016 (HealthDay News) -- Statins could significantly reduce the risk of infection in stroke patients, according to a study published online June 9 in the Journal of Stroke and Cerebrovascular Diseases.

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APCs, Doctors Order Low-Value Services With Similar Frequency

WEDNESDAY, June 22, 2016 (HealthDay News) -- Advanced practice clinicians (APCs) and physicians order low-value health services with similar frequency, according to a study published online June 20 in the Annals of Internal Medicine.

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Vitamin K Antagonists Appear to Be Well Tolerated

WEDNESDAY, June 22, 2016 (HealthDay News) -- Vitamin K antagonists (VKA) are well tolerated and have a minimal effect on quality of life, according to a study published online June 21 in Circulation: Cardiovascular Quality and Outcomes.

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Nine-Protein Risk Score May Help Predict CV Events in Stable CHD

WEDNESDAY, June 22, 2016 (HealthDay News) -- A nine-protein risk score may help predict cardiovascular events among patients with stable coronary heart disease (CHD), according to a study published in the June 21 issue of the Journal of the American Medical Association.

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Tips Provided for Leveraging Social Media

TUESDAY, June 21, 2016 (HealthDay News) -- During a presentation at the 2016 American Medical Association Annual Meeting, Kevin Pho, M.D., founder and editor of the popular physician blog KevinMD, shared insights into making a difference in health care through use of social media.

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Too Many A-Fib Patients Taking Aspirin Instead of Anticoagulant

TUESDAY, June 21, 2016 (HealthDay News) -- More than one-third of U.S. patients with atrial fibrillation who need anticoagulation to prevent strokes aren't receiving it, according to a study published in the June 28 issue of the Journal of the American College of Cardiology.

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Moderately Low LDL May Be Enough to Ward Off CVD Risk

TUESDAY, June 21, 2016 (HealthDay News) -- Very low target low-density lipoprotein (LDL) cholesterol levels may not benefit all patients with preexisting heart disease, according to a study published online June 20 in JAMA Internal Medicine.

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Three-Drug Tx Ups Survival in Light-Chain Amyloidosis

TUESDAY, June 21, 2016 (HealthDay News) -- For patients with heart failure due to light-chain amyloidosis (AL), three-drug therapy with bortezomib, dexamethasone, and an alkylating agent (BDex+AA) is associated with improved survival, according to a study published in the June 28 issue of the Journal of the American College of Cardiology.

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Persistent High Spending Common in Year Before Death

TUESDAY, June 21, 2016 (HealthDay News) -- Almost half of older Medicare beneficiaries have high persistent spending throughout the full year before death, according to a study published in the June issue of Health Affairs.

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Reset Room Can Help Address Physician Burnout

MONDAY, June 20, 2016 (HealthDay News) -- The creation of a reset room is one of several solutions that can help physicians and medical providers address burnout, according to a report published by the American Medical Association.

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TAVI Can Be Performed Without ICU Admission

MONDAY, June 20, 2016 (HealthDay News) -- Transcatheter aortic valve implantation (TAVI) can be performed in low-risk patients without admission to the intensive care unit (ICU), according to a study published in the July 1 issue of The American Journal of Cardiology.

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One Free Meal From Industry Ups Brand-Name Rx Among Doctors

MONDAY, June 20, 2016 (HealthDay News) -- Physicians who receive even one free meal, valued at less than $20 on average, are more likely to prescribe a promoted brand-name drug than a cheaper generic alternative, compared with doctors who did not accept a meal, according to a study published online June 20 in JAMA Internal Medicine.

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Early Discharge After Primary PCI Deemed Safe in STEMI

MONDAY, June 20, 2016 (HealthDay News) -- For patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI), an early discharge strategy within 48 to 56 hours is safe, according to a study published in the June 15 issue of The American Journal of Cardiology.

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Strategy Needed to Address Impending Physician Shortage

FRIDAY, June 17, 2016 (HealthDay News) -- Steps should be taken to combat the impending physician shortage of between 61,700 and 94,700 doctors that the United States is expected to face over the next decade, according to an article published in Medical Economics.

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Recombinant tPA Safe for Patients With Wake-Up Stroke

FRIDAY, June 17, 2016 (HealthDay News) -- For patients with wake-up stroke (WUS), treatment with recombinant tissue plasminogen activator (rtPA) seems safe, according to a study published online June 6 in the Annals of Neurology.

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Varying Safety of Add-On Second-Line T2DM Treatments

FRIDAY, June 17, 2016 (HealthDay News) -- For patients with type 2 diabetes who are taking metformin, the risk of cardiovascular events and mortality varies with the addition of different second-line therapies, according to a study published online June 10 in Diabetes, Obesity and Metabolism.

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Pharmacist Involvement Can Improve Cardiovascular Care

THURSDAY, June 16, 2016 (HealthDay News) -- Patients with poorly controlled cardiovascular disease (CVD) risk factors could improve their prognosis by having pharmacists help manage their care, according to a study published in the June 21 issue of the Journal of the American College of Cardiology.

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Potential Impact of Single-Payer Health Care Discussed

THURSDAY, June 16, 2016 (HealthDay News) -- Democratic presidential candidate Bernie Sanders is promoting his version of single-payer health care, although the actual impact of such a system is unclear, according to a report published in Medical Economics.

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Prices for Care Rise Significantly As Multi-Hospital Systems Emerge

THURSDAY, June 16, 2016 (HealthDay News) -- Hospital prices in California increased substantially from 2004 to 2013, with a larger increase in hospitals that are members of multi-hospital systems, according to a study published online June 9 in Inquiry.

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Sleep-Disordered Breathing Ups Risk of Complications After PCI

THURSDAY, June 16, 2016 (HealthDay News) -- Sleep-disordered breathing (SDB) may increase the risk of serious complications in patients who have undergone percutaneous coronary intervention (PCI), according to research published online June 15 in the Journal of the American Heart Association.

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Several Heart Conditions Affected Differently by Alcohol

WEDNESDAY, June 15, 2016 (HealthDay News) -- Texans living in "dry" counties are more likely to suffer myocardial infarction and congestive heart failure than those living in nearby "wet" counties, where alcohol sales are legal; however, atrial fibrillation is less likely in dry counties, according to a study published online June 14 in The BMJ.

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Preemies' Hearts Benefit From Breastfeeding in the Long Term

WEDNESDAY, June 15, 2016 (HealthDay News) -- Breastfeeding premature infants appears to increase the likelihood that those infants will have healthier hearts in young adulthood, according to research published online June 14 in Pediatrics.

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Very Few Cases of Chest Pain Seen in ER Are Life-Threatening

WEDNESDAY, June 15, 2016 (HealthDay News) -- Less than 6 percent of patients presenting to the emergency department with chest pain suffer from life-threatening conditions such as a heart attack, according to a research letter published online June 13 in JAMA Internal Medicine.

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Four-Step Strategy Suggested for Boosting Practice Quality of Care

WEDNESDAY, June 15, 2016 (HealthDay News) -- Four steps can help doctors improve patient care and office efficiency, according to a report published by the American Medical Association (AMA).

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Long-Acting Opioids May Increase Risk of All-Cause Mortality

TUESDAY, June 14, 2016 (HealthDay News) -- Opioid use may significantly increase mortality risk, according to a study published in the June 14 issue of the Journal of the American Medical Association.

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Even Short-Term T2DM Remission Reduces Risk of Microvascular Dz

TUESDAY, June 14, 2016 (HealthDay News) -- For patients with type 2 diabetes, remission after bariatric surgery is associated with a reduced risk of microvascular disease, even after subsequent relapse, according to a study published online June 6 in Diabetes Care.

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Ultrasound Beats Palpation for Femoral Artery Catheterization

MONDAY, June 13, 2016 (HealthDay News) -- For children undergoing heart surgery, real-time ultrasound guidance is superior to a palpation technique for femoral artery catheterization, according to a study published online June 1 in Pediatric Anesthesia.

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Persistent Depression Linked to Increased CAC Scores in Women

MONDAY, June 13, 2016 (HealthDay News) -- Persistent depressive symptoms are associated with increased coronary artery calcium (CAC) scores among middle-aged women without cardiovascular disease (CVD), according to a study published in the June 15 issue of The American Journal of Cardiology.

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Senior Runners Expend Similar Energy As Younger Runners

FRIDAY, June 10, 2016 (HealthDay News) -- Runners over age 65 could burn oxygen at nearly the same rate as much younger runners, according to a study published in the April issue of Medicine & Science in Sports & Exercise.

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Anemia Independently Linked to High Platelet Reactivity in PCI

THURSDAY, June 9, 2016 (HealthDay News) -- Anemia is independently associated with high platelet reactivity (HPR) and is associated with all-cause mortality and major bleeding after percutaneous coronary intervention with drug-eluting stents, according to a study published in the June 15 issue of The American Journal of Cardiology.

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Temporal hs-cTnT Increase Linked to Risk of CHD, CHF

THURSDAY, June 9, 2016 (HealthDay News) -- Temporal increases in high-sensitivity cardiac troponin T (hs-cTnT) are associated with increased risk of coronary heart disease (CHD), heart failure, and all-cause mortality, according to a study published online June 8 in JAMA Cardiology.

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Renal Function Tests Stratify Risk in Pregnant Women With HTN

THURSDAY, June 9, 2016 (HealthDay News) -- Baseline renal function tests can stratify the risk of severe preeclampsia in pregnant women with chronic hypertension, according to a study published in the July issue of Obstetrics & Gynecology.

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Women With A-Fib Less Likely to Receive Oral Anticoagulants

THURSDAY, June 9, 2016 (HealthDay News) -- Among patients with atrial fibrillation, women are less likely than men to receive oral anticoagulant therapy, according to a study published in the May issue of the Journal of the American Geriatrics Society.

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FDA Warns of Overdoses of Anti-Diarrhea Drug

WEDNESDAY, June 8, 2016 (HealthDay News) -- Overdoses from common anti-diarrhea drugs are being investigated by the U.S. Food and Drug Administration, which warned the drugs can cause potentially fatal heart problems when taken in higher-than-recommended amounts.

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Review: Similar/Improved Outcomes for TAVI Versus SAVR

TUESDAY, June 7, 2016 (HealthDay News) -- Transcatheter aortic valve implantation (TAVI) may be associated with improved clinical outcomes versus surgical aortic valve replacement (SAVR) in adults with severe aortic stenosis, according to a review and meta-analysis published online June 7 in the Annals of Internal Medicine.

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Intraprocedural CCTA Feasible for Identifying Guidewires

TUESDAY, June 7, 2016 (HealthDay News) -- Coronary computed tomographic angiography (CCTA) is feasible for identifying the location of guidewires during chronic total occlusion (CTO) intervention, according to a study published in the June 15 issue of The American Journal of Cardiology.

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Exercise Cuts Cardiac Events in Non-Metastatic Breast Cancer

TUESDAY, June 7, 2016 (HealthDay News) -- For patients with non-metastatic breast cancer, exercise is associated with reductions in the incidence of cardiovascular events, according to a study published online May 23 in the Journal of Clinical Oncology.

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Ventricular Ectopic QRS Interval May Be Useful Post-MI Marker

MONDAY, June 6, 2016 (HealthDay News) -- The ventricular ectopic QRS interval (VEQSI) can identify post-myocardial infarction (MI) patients with prior serious ventricular arrhythmia, according to a study published online June 1 in JACC: Clinical Electrophysiology.

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Few Engage in Five Behaviors for Preventing Chronic Disease

MONDAY, June 6, 2016 (HealthDay News) -- Few U.S. adults engage in all five health-related behaviors recommended for chronic disease prevention, according to a study published online May 26 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Post-CABG Infection Risk Up Significantly for Severely Obese

FRIDAY, June 3, 2016 (HealthDay News) -- Severely obese patients may have a higher risk of certain complications after coronary artery bypass grafting (CABG) surgery than normal-weight patients, according to a study published online June 1 in the Journal of the American Heart Association.

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High-Sensitivity Cardiac Troponin I Assay Shows Efficiency in ER

FRIDAY, June 3, 2016 (HealthDay News) -- A high-sensitivity cardiac troponin I assay can help identify or exclude the diagnosis of myocardial infarction (MI) in the emergency department, according to two studies published online June 1 in JAMA Cardiology.

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Contraindication to Antiplatelet Rx for ~18 Percent With PCI

FRIDAY, June 3, 2016 (HealthDay News) -- About 18 percent of patients undergoing percutaneous coronary intervention (PCI) have a contraindication to commonly used antiplatelet medications, according to a study published online May 31 in Circulation: Cardiovascular Quality and Outcomes.

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AMA Module Promotes Training of Medical Assistants

THURSDAY, June 2, 2016 (HealthDay News) -- A new training module can improve training for medical assistants (MAs), according to a report from the American Medical Association (AMA).

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Decline in Complex Congenital Heart Defects in Down Syndrome

THURSDAY, June 2, 2016 (HealthDay News) -- For infants diagnosed with Down syndrome there has been a reduction in the risk of complex congenital heart defects, according to a study published online June 1 in Pediatrics.

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Genes May Lower Risk of Obesity in Men of West African Descent

THURSDAY, June 2, 2016 (HealthDay News) -- A new study has identified genetic factors in black men with a strong West African ancestry that are associated with a lower risk of central obesity. But this apparent benefit doesn't extend to black women, regardless of their lineage. The study findings were published online June 1 in Frontiers in Genetics.

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Short-Term Risk of Arrhythmia Up With New ADHD Rx

THURSDAY, June 2, 2016 (HealthDay News) -- Methylphenidate can increase the risk of arrhythmias during the first two months of use, according to a study published online May 31 in The BMJ.

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Patients Like to See Physicians Wearing White Coats

THURSDAY, June 2, 2016 (HealthDay News) -- Most patients prefer that physicians wear white coats, according to research published online June 1 in JAMA Dermatology.

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CVD Risk Appears to Be Increased in Women With Migraine

WEDNESDAY, June 1, 2016 (HealthDay News) -- Women who suffer from migraine headaches may have a slightly increased risk of heart disease or stroke, according to a study published online May 31 in The BMJ.

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FDA Urges Food Manufacturers to Reduce Sodium in Their Products

WEDNESDAY, June 1, 2016 (HealthDay News) -- The U.S. Food and Drug Administration wants the food industry to voluntarily reduce the amount of sodium in processed and commercially prepared food.

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More Evidence That Air Pollution Raises Blood Pressure

WEDNESDAY, June 1, 2016 (HealthDay News) -- There is more evidence linking air pollution with increased risk of developing hypertension, according to a review published online May 31 in Hypertension.

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Vigilance Urged for Heparin-Induced Thrombocytopenia

WEDNESDAY, June 1, 2016 (HealthDay News) -- Diagnosis and management of heparin-induced thrombocytopenia (HIT) are discussed in a review published in the May 31 issue of the Journal of the American College of Cardiology.

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