July 2019 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for July 2019. 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.

Biologic Tx for Psoriasis May Reduce Coronary Inflammation

WEDNESDAY, July 31, 2019 (HealthDay News) -- For patients with moderate-to-severe psoriasis, the perivascular fat attenuation index (FAI), as measured by coronary computed tomography angiography (CCTA), indicates reduced coronary inflammation in association with biologic therapy, according to a study published online July 31 in JAMA Cardiology.

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Preeclampsia History Increases Risk for End-Stage Kidney Disease

WEDNESDAY, July 31, 2019 (HealthDay News) -- Women with preeclampsia have an increased risk for developing end-stage kidney disease (ESKD), according to a study published online July 30 in PLOS Medicine.

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Burnout Symptoms May Up Racial Bias Among Resident Physicians

WEDNESDAY, July 31, 2019 (HealthDay News) -- Symptoms of burnout seem to be associated with greater explicit and implicit racial bias among resident physicians, according to a study published online July 26 in JAMA Network Open.

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With Standard Care, BP Control Still Worse in Low-Income Areas

WEDNESDAY, July 31, 2019 (HealthDay News) -- Receiving treatment at clinics in the lowest-income sites is associated with poorer blood pressure control and worse outcomes, according to a study published online July 31 in the Journal of the American Heart Association.

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$70 Million Settlement Reached in Generic Drug Delay Case

TUESDAY, July 30, 2019 (HealthDay News) -- Three drug companies will pay a total of nearly $70 million to California to settle charges of delaying the sale of generic drugs to keep brand-name drug prices high, the state's attorney general said Monday.

AP News Article

Oil, Gas Well Exposure May Up Risk for Congenital Heart Defects

TUESDAY, July 30, 2019 (HealthDay News) -- Pregnant women living near more oil and natural gas development activity have a greater chance of giving birth to children with congenital heart defects (CHDs), according to a study published online July 18 in Environment International.

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National Norms Developed for Assessing Medical School Empathy

TUESDAY, July 30, 2019 (HealthDay News) -- National norms have been developed for assessing empathy among men and women at different levels of medical school education, according to a study published in the August issue of the Journal of the American Osteopathic Association.

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CIED Complication Rates Vary Considerably Among Hospitals

TUESDAY, July 30, 2019 (HealthDay News) -- Cardiovascular implantable electronic device (CIED) complication rates vary considerably among hospitals, according to a study published online July 30 in the Annals of Internal Medicine.

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First Surgery for Ischemic Leg Ulcer May Affect Amputation Risk

TUESDAY, July 30, 2019 (HealthDay News) -- For patients with critical limb ischemia, open surgery first is associated with worse amputation-free survival but not with increased mortality compared with endovascular surgery first, according to a study published online July 30 in Circulation: Cardiovascular Quality and Outcomes.

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Authors Say Lower BP Targets May Cut Recurrent Stroke Risk

MONDAY, July 29, 2019 (HealthDay News) -- Intensive blood pressure (BP) lowering nonsignificantly reduces the risk for recurrence among patients with a history of stroke compared with a standard BP-lowering regimen, according to a study published online July 29 in JAMA Neurology.

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Half of Deaths After Noncardiac Surgery Due to 3 Complications

MONDAY, July 29, 2019 (HealthDay News) -- Three complications account for almost 45 percent of deaths occurring after noncardiac surgery, according to a study published in the July 29 issue of CMAJ, the journal of the Canadian Medical Association.

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AI Model Can Predict Long-Term Mortality From Chest Radiographs

MONDAY, July 29, 2019 (HealthDay News) -- A convolutional neural network (CNN) can predict long-term mortality from chest radiographs (CXRs), according to a study published online July 19 in JAMA Network Open.

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Previous Silent MI Often Found at Autopsy in Sudden Cardiac Death

MONDAY, July 29, 2019 (HealthDay News) -- Autopsies show that more than 40 percent of individuals who experience sudden cardiac death (SCD) associated with coronary artery disease (CAD) have had a previously undetected myocardial infarction, according to a study published online July 10 in JAMA Cardiology.

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Testosterone Replacement Therapy May Increase Cardiovascular Risk

FRIDAY, July 26, 2019 (HealthDay News) -- For aging men with low testosterone levels, testosterone replacement therapy (TRT) may increase the risk of cardiovascular events, especially in the first two years of use, according to a study published in the September issue of The American Journal of Medicine.

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Adherence to Aerobic Activity Guidelines Not Up Since 2008

FRIDAY, July 26, 2019 (HealthDay News) -- Since publication of the Physical Activity Guidelines for Americans (PAG) in 2008, there has been no increase in adherence to aerobic activity guidelines, while sedentary time has increased, according to a study published online July 26 in JAMA Network Open.

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Daily E-Cigarette Use May Increase Prolonged Cigarette Abstinence

FRIDAY, July 26, 2019 (HealthDay News) -- Daily electronic-cigarette use is associated with increased odds of prolonged regular cigarette smoking abstinence, according to a study published online July 11 in Nicotine & Tobacco Research.

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Mortality Up in Women With Central Obesity, Regardless of BMI

FRIDAY, July 26, 2019 (HealthDay News) -- Women with normal-weight central obesity have increased mortality risk compared with normal weight women with no central obesity, according to a study published online July 24 in JAMA Network Open.

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No Indication of 'July Effect' in Context of Cardiac Surgery

THURSDAY, July 25, 2019 (HealthDay News) -- In the context of cardiac surgery, there is no indication of a "July effect," describing worse outcomes in the first month of training, according to a study published online July 25 in the Annals of Thoracic Surgery.

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CDC: Mortality Rates Continue to Decrease for Hispanic Adults

WEDNESDAY, July 24, 2019 (HealthDay News) -- Age-adjusted death rates decreased for Hispanic adults from 2000 through 2017, while for non-Hispanic white and non-Hispanic black adults, the rates have remained stable since 2011-2012, according to a July data brief published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Former NFL Participation Linked to Increased A-Fib Prevalence

WEDNESDAY, July 24, 2019 (HealthDay News) -- Former National Football League (NFL) players have an increased prevalence of atrial fibrillation (AF) and slowed cardiac conduction, according to a study published online July 24 in the Journal of the American Heart Association.

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In-Hospital Cardiac Arrests in the U.S. May Be Underestimated

WEDNESDAY, July 24, 2019 (HealthDay News) -- More patients suffer cardiac arrest in U.S. hospitals each year than previously estimated -- with rates about 38 percent greater for adults and 18 percent greater for children, according to a study published online July 9 in Circulation: Cardiovascular Quality and Outcomes.

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Senate Bill Would Reduce Drug Costs for Seniors

TUESDAY, July 23, 2019 (HealthDay News) -- A bill to reduce prescription drug costs for millions of Medicare recipients and lower federal and state health costs has been introduced by two U.S. senators.

AP News Article

CV Event Risk Up With Rejected, Abandoned PCSK9i Prescriptions

TUESDAY, July 23, 2019 (HealthDay News) -- Patients with rejected or abandoned prescriptions for proprotein convertase subtilisin kexin type 9 inhibitors (PCSK9i) have a significantly increased risk for cardiovascular events than those with paid prescriptions, according to a study published online July 23 in Circulation: Cardiovascular Quality and Outcomes.

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Initiating Stroke Tx 15 Minutes Earlier Can Improve Outcomes

TUESDAY, July 23, 2019 (HealthDay News) -- Shorter time to endovascular-reperfusion therapy is associated with improved outcomes among patients with acute ischemic stroke (AIS) due to large vessel occlusion, according to a study published in the July 16 issue of the Journal of the American Medical Association.

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One in Five Workers Exposed to Secondhand Smoke on the Job

TUESDAY, July 23, 2019 (HealthDay News) -- One in five nonsmoking workers report exposure to secondhand tobacco smoke (SHS) at work, according to research published in the July 12 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Long-Term Diastolic Dysfunction Seen After Early Preeclampsia

TUESDAY, July 23, 2019 (HealthDay News) -- Women with a history of early or preterm preeclampsia have an increased prevalence of diastolic dysfunction, according to a review published online July 2 in the Australasian Journal of Ultrasound in Medicine.

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Almost One in Four Adults ≥40 Takes Aspirin for CVD Prevention

MONDAY, July 22, 2019 (HealthDay News) -- Nearly 30 million U.S. adults aged 40 years or older use aspirin to prevent cardiovascular disease (CVD), including 6.6 million without a physician's recommendation, according to a research letter published online July 23 in the Annals of Internal Medicine.

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Smoking Has Long-Term Impact on Peripheral Artery Disease Risk

MONDAY, July 22, 2019 (HealthDay News) -- Both duration and intensity of smoking have a long-term impact on the risk for three major atherosclerotic diseases: peripheral artery disease (PAD), coronary heart disease (CHD), and stroke, according to a study published in the July 30 issue of the Journal of the American College of Cardiology.

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New ACC/AHA Guidelines Detect More Cases of Gestational Hypertension

MONDAY, July 22, 2019 (HealthDay News) -- Adopting the 2017 American College of Cardiology/American Heart Association guidelines for hypertension resulted in an increase in the prevalence of high blood pressure in pregnant women, according to a study published in the July 5 issue of Circulation Research.

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Financial Incentives Help People Stop Smoking

FRIDAY, July 19, 2019 (HealthDay News) -- Financial incentives do seem to help people quit smoking, according to a study published July 17 in the Cochrane Library.

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Excess Risk for Diabetes-Linked Heart Failure Greater in Women

FRIDAY, July 19, 2019 (HealthDay News) -- The excess risk for heart failure associated with diabetes is significantly greater in women than men, according to a meta-analysis published online July 18 in Diabetologia.

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CDC: Prevalence of Smoking Quit Attempts Unchanged in Most States

THURSDAY, July 18, 2019 (HealthDay News) -- During 2011 to 2017, the prevalence of quit attempts in adult smokers did not change significantly in 44 states and increased in only four states, according to research published in the July 19 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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About One in 20 Patients Exposed to Preventable Harm

THURSDAY, July 18, 2019 (HealthDay News) -- The pooled prevalence of preventable patient harm is 6 percent across a range of medical settings globally, according to a review published online July 17 in The BMJ.

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Systolic, Diastolic HTN Contribute to Adverse CV Events

THURSDAY, July 18, 2019 (HealthDay News) -- Both systolic and diastolic hypertension contribute independently to the risk for adverse cardiovascular events, according to a study published in the July 18 issue of the New England Journal of Medicine.

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People Living With HIV Have Higher Risk for Cardiovascular Disease

THURSDAY, July 18, 2019 (HealthDay News) -- People living with HIV (PLWH) have a higher risk for cardiovascular disease, according to a study published online July 2 in the Journal of the American Heart Association.

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Extremely Low LDL Cholesterol May Up Stroke Risk

WEDNESDAY, July 17, 2019 (HealthDay News) -- Cholesterol levels that are too low may increase the risk for hemorrhagic stroke, according to a study published online July 2 in Neurology.

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Early EEG Helps Predict Cardiac Arrest Outcomes in Comatose

WEDNESDAY, July 17, 2019 (HealthDay News) -- Early electroencephalography (EEG) reliably predicts the outcome of comatose patients after cardiac arrest, according to a study recently published in the Annals of Neurology.

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Prevalence of Malignancy High in Takotsubo Syndrome Patients

WEDNESDAY, July 17, 2019 (HealthDay News) -- Overall, 16.6 percent of patients with takotsubo syndrome (TTS) have malignancy, and long-term mortality is higher in patients with malignancy, according to a study published online July 17 in the Journal of the American Heart Association.

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Subclinical Cardiovascular Dz May Up Fall Risk in Older Adults

WEDNESDAY, July 17, 2019 (HealthDay News) -- Subclinical cardiovascular disease (CVD) appears to be an independent risk factor for falls in older adults, according to a study published online July 10 in the Journal of the American Geriatrics Society.

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Most Adults Favor Cutting Nicotine Levels in Cigarettes

TUESDAY, July 16, 2019 (HealthDay News) -- Most adults favor requiring cigarette makers to lower the level of nicotine in cigarettes, according to a study published online July 11 in the American Journal of Preventive Medicine.

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Alirocumab Cuts CV Absolute Risk the Most for Those With Diabetes

TUESDAY, July 16, 2019 (HealthDay News) -- Among those receiving alirocumab in addition to statin therapy to reduce the risk for another cardiovascular event after a recent acute coronary syndrome, absolute risk reduction is greater for those with diabetes, according to a study published online July 1 in The Lancet Diabetes & Endocrinology.

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Non-Vitamin K Oral Anticoagulants May Be Best for Early-Stage CKD

TUESDAY, July 16, 2019 (HealthDay News) -- Non-vitamin K oral anticoagulants (NOACs) have a superior benefit-risk profile to that of vitamin K antagonists (VKAs) for patients with early-stage chronic kidney disease (CKD), according to a review published online July 16 in the Annals of Internal Medicine.

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CVD Risk Up in Later Life for Young Adults With High LDL or Hypertension

TUESDAY, July 16, 2019 (HealthDay News) -- Young adult exposures to elevated systolic and diastolic blood pressure (SBP and DBP) and low-density lipoprotein (LDL) are associated with increased risks for cardiovascular disease (CVD) in later life, according to a study published in the July 23 issue of the Journal of the American College of Cardiology.

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Frequent Fried Food Intake Increases Risk for Coronary Artery Disease

MONDAY, July 15, 2019 (HealthDay News) -- The frequency of fried food consumption shows a positive linear relationship with the risk for coronary artery disease (CAD), according to a study recently published in Clinical Nutrition.

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Race, Neighborhood Impact Bystander CPR in Pediatric OHCA

MONDAY, July 15, 2019 (HealthDay News) -- For pediatric out-of-hospital cardiac arrest (OHCA), racial and neighborhood characteristics are associated with bystander cardiopulmonary resuscitation (BCPR), according to a study published online July 10 in the Journal of the American Heart Association.

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Risk for Arterial Hypertension Up With Air Pollutant Exposure

MONDAY, July 15, 2019 (HealthDay News) -- For individuals living in multistory houses (MH), residential exposure to air pollutants is associated with an increased risk for arterial hypertension (AH), according to a study published online June 24 in the Journal of Public Health.

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Risk for Leg Amputation Higher With Microvascular Disease

FRIDAY, July 12, 2019 (HealthDay News) -- Microvascular disease (MVD) increases the risk for amputation alone and in combination with peripheral artery disease (PAD), according to a study published online July 8 in Circulation.

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Prolonged TV Viewing Tied to CVD Events, Mortality in Blacks

FRIDAY, July 12, 2019 (HealthDay News) -- Prolonged television viewing, but not occupational sitting, is associated with an increased risk for cardiovascular disease (CVD) events and all-cause mortality in blacks, according to a study published in the July 2 issue of the Journal of the American Heart Association.

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Serious Misdiagnosis-Related Harms Mostly Due to 'Big Three'

FRIDAY, July 12, 2019 (HealthDay News) -- Vascular events, infections, and cancers account for about three-quarters of serious misdiagnosis-related harms, according to a study published online July 11 in Diagnosis.

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Erectile Dysfunction Presents Large Global Health Burden

FRIDAY, July 12, 2019 (HealthDay News) -- Erectile dysfunction (ED) is a large global burden and is associated with increased risks for cardiovascular disease, dementia, and early death, according to a review published online July 2 in BJU International.

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Capping Work Hours in Residency Does Not Impact Outcomes Later

THURSDAY, July 11, 2019 (HealthDay News) -- Exposure of U.S. physicians to work-hour reforms during residency training is not associated with post-training differences in patient mortality, readmissions, or costs of care, according to a study published online July 11 in The BMJ.

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Medicare Drug Rebate Plan Withdrawn by Trump Administration

THURSDAY, July 11, 2019 (HealthDay News) -- A plan to let Medicare patients receive rebates that drug companies currently pay to insurers and middlemen has been withdrawn by the Trump administration.

AP News Article

Uncontrolled Diabetes, Hypertension Rates High in CKD Patients

THURSDAY, July 11, 2019 (HealthDay News) -- For patients with chronic kidney disease (CKD), the prevalence of uncontrolled hypertension and diabetes is high and has not improved over time, according to a study published online July 11 in the Clinical Journal of the American Society of Nephrology.

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Elevated Systolic BP May Up Risk for Valvular Heart Disease

THURSDAY, July 11, 2019 (HealthDay News) -- The cumulative effect of elevated systolic blood pressure appears to be associated with an increased risk for major valvular heart disease, according to a study published online July 10 in JAMA Cardiology.

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PE, Death Not Reduced With Early Vena Cava Filter Placement

THURSDAY, July 11, 2019 (HealthDay News) -- Early prophylactic placement of a vena cava filter compared with no placement of a filter after major trauma does not result in a reduced incidence of symptomatic pulmonary embolism or death at 90 days, according to a study published online July 7 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the International Society on Thrombosis and Haemostasis, held from July 6 to 10 in Melbourne, Australia.

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Health Care Professionals Exhibit Gender Bias

THURSDAY, July 11, 2019 (HealthDay News) -- Survey results show that health care professionals have implicit and explicit gender bias, according to a study published online July 5 in JAMA Network Open.

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Risk for Cancer Higher in Those With Congenital Heart Disease

WEDNESDAY, July 10, 2019 (HealthDay News) -- Children and young adult patients with congenital heart disease (CHD) have an increased risk for developing cancer, according to a study published online July 5 in JAMA Network Open.

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CPAP Alleviates Depression Symptoms in Sleep Apnea Patients

WEDNESDAY, July 10, 2019 (HealthDay News) -- Continuous positive airway pressure (CPAP) treatment reduces depression symptoms in patients with coexisting obstructive sleep apnea (OSA) and cardiovascular disease, according to research published online June 13 in EClinicalMedicine.

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Rule Requiring Drug Prices in TV Ads Blocked by Judge

TUESDAY, July 9, 2019 (HealthDay News) -- A Trump administration rule to force pharmaceutical companies to disclose the list prices of their drugs in television ads was blocked Monday by a federal judge.

The New York Times Article

EHR System-Generated In-Basket Messages Linked to Burnout

TUESDAY, July 9, 2019 (HealthDay News) -- Receipt of more than the average number of electronic health record (EHR) system-generated in-basket messages is associated with an increased probability of physician burnout, according to a study published in the July 1 issue of Health Affairs.

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Environment May Be Main Factor in Norway's Obesity Epidemic

TUESDAY, July 9, 2019 (HealthDay News) -- Environment most likely remains the main contributor to the obesity epidemic in Norway, given that body mass index (BMI) has increased for both genetically predisposed and nonpredisposed people since the 1960s, according to a study published online July 3 in The BMJ.

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In-Hospital Maternal Mortality Down in Pregnancies With Lupus

TUESDAY, July 9, 2019 (HealthDay News) -- In-hospital maternal mortality decreased from 1998 to 2015 in systemic lupus erythematosus (SLE) and non-SLE pregnancies, with a greater decline for SLE pregnancies, according to a study published online July 9 in the Annals of Internal Medicine.

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History of Liver Disease Does Not Impact Efficacy of Edoxaban

TUESDAY, July 9, 2019 (HealthDay News) -- For patients with atrial fibrillation (AF), the efficacy and safety of edoxaban versus warfarin is not altered with a history of liver disease, according to a study published in the July 16 issue of the Journal of the American College of Cardiology.

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Consistent Time of Day Aids Workout Habit

MONDAY, July 8, 2019 (HealthDay News) -- Consistency in timing of workouts may help sustain high physical activity levels among adults successfully maintaining weight loss, according to a study published online July 3 in Obesity.

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Most Supplements Offer Little Protection Against Heart Disease

MONDAY, July 8, 2019 (HealthDay News) -- Certain nutritional supplements and dietary interventions may reduce the risk for some cardiovascular outcomes in adults; however, the overall effect of nutritional supplements on cardiovascular disease outcomes remains unclear, according to a review published online July 9 in the Annals of Internal Medicine.

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Infective Endocarditis Prevalence 26 Percent in Patients With E. faecalis

MONDAY, July 8, 2019 (HealthDay News) -- The prevalence of infective endocarditis (IE) is about 26 percent among patients with Enterococcus faecalis bacteremia, according to a study published in the July 16 issue of the Journal of the American College of Cardiology.

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Regional Fat With Normal BMI Affects CVD Risk After Menopause

WEDNESDAY, July 3, 2019 (HealthDay News) -- For postmenopausal women with normal body mass index (BMI), higher percent trunk fat is associated with elevated cardiovascular disease (CVD) risk, while higher percent leg fat is associated with lower CVD risk, according to a study published online June 30 in the European Heart Journal.

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Considerable Number of Patients Receive Surprise Hospital Charges

TUESDAY, July 2, 2019 (HealthDay News) -- Eighteen percent of all emergency department visits and 16 percent of in-network hospital stays have at least one out-of-network charge, according to a report published June 20 by the Kaiser Family Foundation.

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Guidance Issued for Management of Fontan Circulation

TUESDAY, July 2, 2019 (HealthDay News) -- A scientific statement with recommendations for follow-up care in patients with Fontan circulation surviving into adulthood was published online July 1 in Circulation.

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Statin Use Associated With Higher Incidence of Diabetes

TUESDAY, July 2, 2019 (HealthDay News) -- There may be a dose-dependent relationship between statin therapy and new-onset diabetes across the duration of statin use, according to a study recently published in Diabetes Metabolism Research and Reviews.

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AI Model Better Predicts CV Risk, Mortality Using Cardiac Imaging

MONDAY, July 1, 2019 (HealthDay News) -- Machine learning models of vessel features from coronary computed tomography (CT) angiography better discriminate patients with versus without subsequent death and cardiovascular events, according to a study published online June 25 in Radiology.

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High-Sensitivity Troponin Levels Can Predict MI Risk

MONDAY, July 1, 2019 (HealthDay News) -- For patients presenting to the emergency department with symptoms suggestive of myocardial infarction, a tool developed to integrate high-sensitivity troponin I or T concentrations and dynamic change during serial sampling can estimate the probability of myocardial infarction and 30-day outcomes, according to a study published in the June 27 issue of the New England Journal of Medicine.

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Longevity Benefits for Adults Becoming More Physically Active

MONDAY, July 1, 2019 (HealthDay News) -- Middle-aged and older adults, including those with cancer and cardiovascular disease, can gain longevity benefits by becoming more physically active, according to a study published online June 26 in The BMJ.

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Leisure-Time Physical Activity Linked to Lower SAH Risk

MONDAY, July 1, 2019 (HealthDay News) -- Leisure-time physical activity (LTPA) is associated with reduced risk of aneurysmal subarachnoid hemorrhage (SAH), according to a study published online June 25 in Scientific Reports.

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Low Vitamin D in Early Life May Up Risk of Elevated Systolic BP

MONDAY, July 1, 2019 (HealthDay News) -- Low vitamin D status and trajectory in early life are associated with increased risk of elevated systolic blood pressure (SBP) during childhood, according to a study published online July 1 in Hypertension.

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