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December 2017 Briefing – Cardiology

December 2017 Briefing – Cardiology
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Here are what the editors at HealthDay consider to be the most important developments in Cardiology for December 2017. 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.

Guidelines Developed for Optimizing Treatment of HFrEF

THURSDAY, Dec. 28, 2017 (HealthDay News) — Guidelines have been developed to help optimize treatment of heart failure with reduced ejection fraction (HFrEF), according to an Expert Consensus Decision Pathway published online Dec. 22 in the Journal of the American College of Cardiology.

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MRI Seems Safe for Patients With Legacy Pacemaker, ICD System

WEDNESDAY, Dec. 27, 2018 (HealthDay News) — For patients with a legacy pacemaker or implantable cardioverter-defibrillator system, magnetic resonance imaging (MRI) conducted at a strength of 1.5 Tesla is safe, according to a study published in the Dec. 28 issue of the New England Journal of Medicine.

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Smoking Cessation Drug Tied to Increased Cardiovascular Risk

WEDNESDAY, Dec. 27, 2017 (HealthDay News) — Individuals taking varenicline for smoking cessation appear to be at increased risk of cardiovascular but not neuropsychiatric events, according to a study published online Dec. 20 in the American Journal of Respiratory and Critical Care Medicine.

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Rituximab Effective for Lupus-Associated Cytopenia

WEDNESDAY, Dec. 27, 2017 (HealthDay News) — Rituximab treatment seems effective for systemic lupus erythematosus (SLE)-associated immune cytopenias, with an overall initial response rate of 86 percent, according to a study published online Dec. 16 in the American Journal of Hematology.

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Exposure to PM2.5, Ozone at Low Levels Linked to Mortality

WEDNESDAY, Dec. 27, 2017 (HealthDay News) — Short-term exposure to ambient fine particulate matter (PM2.5) and warm-season ozone at levels below current national air quality standards is associated with increased risk of mortality in the U.S. Medicare population, according to a study published in the Dec. 26 issue of the Journal of the American Medical Association.

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Intensive Lifestyle Intervention Linked to Cerebral Blood Flow

WEDNESDAY, Dec. 27, 2017 (HealthDay News) — A long-term intensive lifestyle intervention (ILI) in overweight and obese adults with type 2 diabetes mellitus is associated with greater cerebral blood flow (CBF), according to a study published recently in the Journal of the American Geriatrics Society.

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Multicomponent Strategies Most Effective for BP Control

TUESDAY, Dec. 26, 2017 (HealthDay News) — For patients with hypertension, multilevel, multicomponent strategies, followed by patient-level strategies, are the most effective for blood pressure (BP) control, according to a review published online Dec. 26 in the Annals of Internal Medicine.

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Plasma Volume Changes May Mediate Effects of Empagliflozin

TUESDAY, Dec. 26, 2017 (HealthDay News) — The reduction in risk of cardiovascular (CV) death with empagliflozin is most mediated by changes in hematocrit and hemoglobin, according to research published online Dec. 4 in Diabetes Care.

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Survival Down With Ventricular Arrhythmia Early Post CF-LVAD

TUESDAY, Dec. 26, 2017 (HealthDay News) — For patients post contemporary continuous flow left ventricular assist device (CF-LVAD) implantation, early ventricular arrhythmias (VAs) are associated with significantly reduced survival, according to a study published online Dec. 20 in JACC: Clinical Electrophysiology.

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Gender Differences Seen in Mental Stress-Induced Ischemia

THURSDAY, Dec. 21, 2017 (HealthDay News) — Men and women have different cardiovascular reactivity mechanisms for mental stress-induced myocardial ischemia (MSIMI), according to a study published online Dec. 21 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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CDC: 2015 to 2016 Saw Drop in Life Expectancy in United States

THURSDAY, Dec. 21, 2017 (HealthDay News) — From 2015 to 2016, life expectancy decreased by one-tenth of a year, and there was an increase in the rate of age-adjusted drug overdose deaths, according to two December data briefs published by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

Abstract/Full Text – Kochanek
Abstract/Full Text – Hedegaard

Interruption of Apixaban Doesn’t Impact Bleeding in A-Fib

THURSDAY, Dec. 21, 2017 (HealthDay News) — For patients undergoing catheter ablation for nonvalvular atrial fibrillation (AF), both uninterrupted and minimally interrupted apixaban are associated with a very low rate of thromboembolic events, according to a study published online Dec. 20 in JACC: Clinical Electrophysiology.

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Medicare Costs Associated With Mortality Rates in AMI Patients

WEDNESDAY, Dec. 20, 2017 (HealthDay News) — For patients hospitalized with acute myocardial infarction, Medicare expenditure growth is associated with reduced 180-day case fatality, according to a study published online Dec. 20 in JAMA Cardiology.

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Switching Dual Antiplatelet Therapy Beneficial After ACS

WEDNESDAY, Dec. 20, 2017 (HealthDay News) — Switching dual antiplatelet therapy (DAPT) from aspirin plus ticagrelor or prasugrel to aspirin plus clopidogrel after acute coronary syndrome (ACS) provides benefits regardless of initial platelet reactivity, according to a study published in the Dec. 26 issue of JACC: Cardiovascular Interventions.

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Rx Discrepancies Common in Hospital Discharge Summaries

TUESDAY, Dec. 19, 2017 (HealthDay News) — For older patients discharged from a regional hospital, there are frequently discrepancies between the electronic discharge summaries and the National Inpatient Medication Chart (NIMC) or discharge prescription, according to a study published online Dec. 13 in the Journal of Pharmacy Practice and Research.

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STEMI Patient Perceptions Impact Emergency Medical Services Use

TUESDAY, Dec. 19, 2017 (HealthDay News) — ST-elevation myocardial infarction (STEMI) patient perceptions, including those involving the speed of transport and concerns about resource misuse, are an important factor in determining emergency medical services (EMS) use, according to a study published online Dec. 13 in the Journal of Evaluation in Clinical Practice.

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Gingko Biloba Extract Found Effective in Acute Ischemic Stroke

TUESDAY, Dec. 19, 2017 (HealthDay News) — For acute ischemic stroke, Ginkgo biloba extract (GBE) in combination with aspirin alleviates cognitive and neurological deficits, according to a study published online Dec. 18 in Stroke and Vascular Neurology.

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Intensive BP Goals Reduce Risk of Cardiovascular Events

TUESDAY, Dec. 19, 2017 (HealthDay News) — Intensive blood pressure lowering may similarly decrease cardiovascular events in both patients with and patients without type 2 diabetes mellitus, according to a study published online Dec. 6 in Diabetes Care.

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USPSTF Reviews Use of ECG for Preventing A-Fib, CVD Events

TUESDAY, Dec. 19, 2017 (HealthDay News) — The U.S. Preventive Services Task Force (USPSTF) has found that the current evidence is inadequate to assess the benefits and harms of screening with electrocardiogram (ECG) for atrial fibrillation (AF) in older adults; and for low-risk adults, screening with resting or exercise ECG is not recommended for preventing cardiovascular disease (CVD) events. These findings form the basis of two draft recommendation statements published online Dec. 19 by the USPSTF.

Evidence Review – A-FIB
Draft Recommendation Statement – A-FIB
Comment on Recommendation Statement – A-FIB
Evidence Review – CVD
Draft Recommendation Statement – CVD
Comment on Recommendation Statement – CVD

Male U.S. Doctors Receive Higher Values of Industry Payments

MONDAY, Dec. 18, 2017 (HealthDay News) — Male physicians in the United States received higher values of general payments from industry than females in 2015, according to a research letter published online Dec. 18 in JAMA Internal Medicine.

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Year One Results Out for Value-Based Payment Modifier Program

MONDAY, Dec. 18, 2017 (HealthDay News) — Almost 30 percent of eligible practices failed to register and report data in the first year of the Physician Value-Based Payment Modifier program, according to a report published in the December issue of Health Affairs.

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Payment for Laboratory Tests Set to Reduce Starting Jan. 1, 2018

MONDAY, Dec. 18, 2017 (HealthDay News) — The Centers for Medicare & Medicaid Services (CMS) has released the Clinical Laboratory Fee Schedule, which is set to reduce payments for testing services conducted in physician office-based laboratories, according to a report published by the American Medical Association (AMA).

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Doctors Must Report on at Least 1 Patient, 1 Measure for MACRA

FRIDAY, Dec. 15, 2017 (HealthDay News) — In order to meet the 2017 Medicare and CHIP Reauthorization Act (MACRA) participation reporting deadline and avoid a Medicare payment penalty in 2019, physicians must report on at least one patient and one measure by Dec. 31, and submit to Medicare no later than Feb. 28, 2018, according to a report from the American Medical Association (AMA).

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Pharmacist Participation in Medical Homes Aids Outcomes

FRIDAY, Dec. 15, 2017 (HealthDay News) — A program that integrates clinical pharmacists into established primary care medical home practices helps patients achieve better disease management for high blood pressure (HBP) and diabetes mellitus (DM), compared to usual care, according to a study published recently in the Journal of International Medical Research.

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Expanded TIMI Risk Score Deemed Practical in Diabetes

FRIDAY, Dec. 15, 2017 (HealthDay News) — The TIMI (Thrombolysis in Myocardial Infarction) Risk Score for Secondary Prevention (TRS 2°P) is an accurate predictor of atherothrombotic disease among patients with type 2 diabetes, according to a study published online Dec. 1 in Diabetes Care.

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Making Insurers Participate in Marketplace Could Cut Volatility

THURSDAY, Dec. 14, 2017 (HealthDay News) — Requiring insurers that participate in Medicare or Medicaid to also participate in Marketplaces in the same geographic area could improve access to insurance, according to a study published in the December issue of Health Affairs.

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Stereotactic Body Radiation Can Cut Ventricular Tachycardia

THURSDAY, Dec. 14, 2017 (HealthDay News) — Noninvasive mapping of cardiac arrhythmias with electrocardiographic imaging and noninvasive delivery of precise ablative radiation with stereotactic body radiation therapy (SBRT) can reduce the burden of ventricular tachycardia, according to a study published in the Dec. 14 issue of the New England Journal of Medicine.

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Serial hsTnT Level IDs Risk of 30-Day Adverse Cardiac Event

WEDNESDAY, Dec. 13, 2017 (HealthDay News) — High-sensitivity troponin (hsTnT) assay can identify patients presenting with suspected acute coronary syndrome at very low risk for 30-day adverse cardiac events (ACE), according to a study published online Dec. 13 in JAMA Cardiology.

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In Utero Methylphenidate Exposure Tied to Heart Defects

WEDNESDAY, Dec. 13, 2017 (HealthDay News) — Intrauterine exposure to methylphenidate is associated with a small increase in the risk of cardiac malformations, according to a study published online Dec. 13 in JAMA Psychiatry.

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Observation Care Cost Saving in Commercially-Insured Patients

WEDNESDAY, Dec. 13, 2017 (HealthDay News) — Among commercially-insured patients, the cost of observation care has increased, but it is still lower than spending for short-stay hospitalizations, according to a report published in the December issue of Health Affairs.

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Hydroquinidine Cuts Serious Arrhythmic Events in SQTS

WEDNESDAY, Dec. 13, 2017 (HealthDay News) — Treatment with hydroquinidine (HQ) prolongs the QT interval in patients with short QT syndrome (SQTS) and reduces the occurrence of life-threatening arrhythmic events (LAE), according to a study published in the Dec. 19 issue of the Journal of the American College of Cardiology.

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FDA OKs Nucala for Eosinophilic Granulomatosis With Polyangiitis

TUESDAY, Dec. 12, 2017 (HealthDay News) — Nucala (mepolizumab) has been approved by the U.S. Food and Drug Administration as the first drug to treat adults with eosinophilic granulomatosis with polyangiitis, a rare autoimmune disease that leads to vasculitis.

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Atherosclerosis ID’d in Many Without CV Risk Factors

TUESDAY, Dec. 12, 2017 (HealthDay News) — Many individuals without cardiovascular risk factors (CVRFs) have atherosclerosis, with low-density lipoprotein cholesterol (LDL-C) independently associated with the presence and extent of atherosclerosis, according to a study published in the Dec. 19 issue of the Journal of the American College of Cardiology.

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CABG May Be Best Method to Revascularize in Diabetes

TUESDAY, Dec. 12, 2017 (HealthDay News) — In patients with diabetes and multivessel coronary artery disease (MV-CAD), coronary artery bypass grafting (CABG) may be the preferred method of revascularization, with lower rates of major adverse cardiac or cerebrovascular events (MACCE), according to a study published in the Dec. 19 issue of the Journal of the American College of Cardiology.

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In-Hospital Deaths in A-Fib Patients Higher in Rural Areas

MONDAY, Dec. 11, 2017 (HealthDay News) — In-hospital mortality among patients with atrial fibrillation (AF) is higher in rural hospitals than in urban hospitals, according to a study published online Dec. 11 in Heart Rhythm.

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Deceleration in Health Care Spending Growth in 2016

MONDAY, Dec. 11, 2017 (HealthDay News) — Health care spending growth slowed in 2016 following faster growth in 2014 and 2015, according to research published online Dec. 6 in Health Affairs.

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Dopamine Receptor Antagonist Antipsychotic Tx Can Affect BP

FRIDAY, Dec. 8, 2017 (HealthDay News) — Use of dopaminergic antagonists and agonists can affect blood pressure (BP), according to a review published online Nov. 8 in the Journal of Clinical Pharmacy and Therapeutics.

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ORBIT Bleeding Risk Score Performs Best in A-Fib

FRIDAY, Dec. 8, 2017 (HealthDay News) — Four contemporary clinical bleeding risk scores are able to identify atrial fibrillation (AF) patients at risk for major bleeding and life-threatening bleeding, according to a study published online Nov. 7 in the Journal of Internal Medicine.

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Novel Subcutaneous Furosemide May Be Option in Heart Failure

FRIDAY, Dec. 8, 2017 (HealthDay News) — A novel, pH-neutral furosemide formulation administered subcutaneously (SC) in outpatients with worsening heart failure appears to be safe and effective, according to a study published online Dec. 6 in JACC: Heart Failure.

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MedDiet Adherence Doesn’t Affect Acute Heart Failure Mortality

THURSDAY, Dec. 7, 2017 (HealthDay News) — For patients with acute heart failure, adherence to the Mediterranean diet (MedDiet) does not influence long-term mortality, according to a study published online Dec. 6 in JACC: Heart Failure.

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Moving More May Match Focused Exercise in Prediabetes

THURSDAY, Dec. 7, 2017 (HealthDay News) — The accumulation of total physical activity (PA) over the day may be as important as achieving the intensity of moderate-to-vigorous PA (MVPA) for improved cardiometabolic health of adults with prediabetes, according to a study published online Nov. 20 in Diabetes Care.

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Metabolic Risk Factors Linked to Severe Liver Disease

THURSDAY, Dec. 7, 2017 (HealthDay News) — Metabolic risk factors are associated with severe liver disease, according to a study published online Nov. 22 in Hepatology.

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In CAD With GI Bleeding, Higher Mortality With Triple Therapy

WEDNESDAY, Dec. 6, 2017 (HealthDay News) — For patients with lower gastrointestinal bleeding (LGIB) and coronary artery disease (CAD), triple therapy is associated with increased risk of mortality at 90 days after adjustment for confounding variables, according to a study published online Nov. 20 in the Journal of Gastroenterology and Hepatology.

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Traffic Pollution Prevents Cardiac Benefits of Walking

WEDNESDAY, Dec. 6, 2017 (HealthDay News) — The beneficial cardiopulmonary effects of walking are attenuated when walking in a traffic polluted area, according to a study published online Dec. 5 in The Lancet.

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State Newborn Screening Policies Cut Infant Cardiac Deaths

TUESDAY, Dec. 5, 2017 (HealthDay News) — Implementation of state newborn screening policies for critical congenital heart disease is associated with a decrease in infant cardiac deaths, according to a study published in the Dec. 5 issue of the Journal of the American Medical Association.

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30-Day Mortality No Different for Treatment by Locum Tenens

TUESDAY, Dec. 5, 2017 (HealthDay News) — Overall 30-day mortality does not differ for patients treated by locum tenens and non-locum tenens internal medicine physicians, according to a study published in the Dec. 5 issue of the Journal of the American Medical Association.

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Antithrombotics Deemed Safe in Carpal Tunnel Release Surgery

TUESDAY, Dec. 5, 2017 (HealthDay News) — For patients undergoing wide-awake carpal tunnel release (CTR) surgery, antithrombotic (AT) agents may be safely continued, according to a research letter published online Nov. 29 in JAMA Surgery.

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Lipid-Linked Genetic Risk Tied to Abdominal Aortic Aneurysm

TUESDAY, Dec. 5, 2017 (HealthDay News) — Lipid-associated genetic risk correlates with the risk of abdominal aortic aneurysm (AAA), according to a study published online Nov. 29 in JAMA Cardiology.

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CVS-Aetna Merger Has Implications for Doctors’ Offices

TUESDAY, Dec. 5, 2017 (HealthDay News) — CVS Health’s planned purchase of insurance giant Aetna, a $69 billion deal, was announced Sunday.

More Information – NYT
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Relevant Health Care Price Info Hard to Find Online

MONDAY, Dec. 4, 2017 (HealthDay News) — Overall, 17 percent of websites provide geographically relevant health care price estimates relating to specific interventions, according to a research letter published online Dec. 4 in JAMA Internal Medicine.

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Specialty Care Tied to Reduced Mortality in New-Onset A-Fib

MONDAY, Dec. 4, 2017 (HealthDay News) — Cardiologist care is associated with a lower rate of death in patients with new-onset atrial fibrillation (AF), according to a study published in the December issue of the Canadian Journal of Cardiology.

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Editorial

Odds for Carotid Artery Stenting in Seniors Up Post-CREST Era

MONDAY, Dec. 4, 2017 (HealthDay News) — The odds of carotid artery stenting (CAS) have increased in the post-Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) era, despite safety concerns for patients older than 70 years, according to a study published online Dec. 4 in JAMA Neurology.

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Almonds With/Without Chocolate May Improve Lipid Profiles

FRIDAY, Dec. 1, 2017 (HealthDay News) — Eating raw almonds, dark chocolate, and cocoa can significantly improve lipid profiles of overweight and obese people, according to a small study published online Nov. 29 in the Journal of the American Heart Association.

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ACC Guides Treatment of Bleeding With Oral Anticoagulation

FRIDAY, Dec. 1, 2017 (HealthDay News) — A decision pathway has been developed to guide management of acute bleeding in patients treated with oral anticoagulants (OACs); the decision pathway was published online Dec. 1 in the Journal of the American College of Cardiology.

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Storage in Dose Administration Aids Doesn’t Affect Warfarin

FRIDAY, Dec. 1, 2017 (HealthDay News) — The chemical stability of warfarin sodium tablets is not affected by repackaging into dose administration aids (DAAs), according to a study published online Nov. 16 in the Journal of Pharmacy Practice and Research.

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