April 2018 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for April 2018. 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.

Review: Need to Strengthen Natural Experiments in Obesity

MONDAY, April 30, 2018 -- Based on findings from a systematic review of the literature, recommendations have been developed for improving the evidence for natural experiments in obesity; the review and position paper were published online May 1 in the Annals of Internal Medicine.

Reforms Suggested for Improving Medical Nutrition Education

MONDAY, April 30, 2018 -- Enhancing physician education and training in nutrition is expected to improve engagement in diet counseling for outpatients with atherosclerotic cardiovascular disease (ASCVD), according to an American Heart Association science advisory published online April 30 in Circulation.

Five Healthy Lifestyle Habits Could Add >10 Years to Life

MONDAY, April 30, 2018 -- Adopting a healthy lifestyle, with five low-risk lifestyle factors is associated with increased life expectancy, according to a study published online April 30 in Circulation.

CCHD Newborn Screening May Detect Other Diseases

MONDAY, April 30, 2018 -- Critical congenital heart disease (CCHD) newborn screening detects a low percentage of new cases of CCHD, but it can detect other important diseases, according to a study published online April 24 in Pediatrics.

New Clinic Satisfaction Tool Provides Real-Time Feedback

THURSDAY, April 26, 2018 -- A new clinic satisfaction tool improves communication and provides real-time feedback, according to a study published online April 14 in Neurosurgery.

Sickle Cell Trait Not Linked to Stroke in African-Americans

FRIDAY, April 27, 2018 -- For African-Americans, sickle cell trait (SCT) seems not to be associated with the incidence of ischemic stroke, according to a meta-analysis published online April 23 in JAMA Neurology.

ALS by Physician May Improve Traumatic Arrest Outcomes

FRIDAY, April 27, 2018 -- For patients with traumatic out-of-hospital cardiac arrest (OHCA), pre-hospital advanced life support (ALS) provided by a physician is associated with increased likelihood of one-month survival, according to a study published online April 25 in JAMA Surgery.

Previous Stroke Tied to Higher Risks in Aortic Valve Replacement

FRIDAY, April 27, 2018 -- For patients undergoing surgical aortic valve replacement (SAVR), previous stroke is a risk factor for recurrent ischemic stroke and major adverse cardiovascular events (MACE), according to a study published online April 25 in JAMA Cardiology.

Improvement in Race-Based Disparities in Years of Life Lost

THURSDAY, April 26, 2018 -- From 1990 to 2014 there was a decrease in race-based disparities in years of life lost (YLL) in the United States, according to a study published online April 25 in PLOS ONE.

Tenecteplase Appears Superior to Alteplase After Ischemic Stroke

THURSDAY, April 26, 2018 -- For patients with ischemic stroke, treatment with tenecteplase within 4.5 hours of symptom onset and before thrombectomy is associated with better outcomes than treatment with alteplase during the same timeframe, according to a study published in the April 26 issue the New England Journal of Medicine.

Pros and Cons for E-Cigarettes As Aid to Smoking Cessation

THURSDAY, April 26, 2018 -- Evidence relating to the pros and cons of electronic cigarettes (e-cigarettes) as helpful smoking cessation tools is presented and discussed in a head to head article published online April 25 in The BMJ.

Saturday Is National Prescription Drug Take Back Day

THURSDAY, April 26, 2017 -- The U.S. Drug Enforcement Administration and local agencies are holding the 15th National Prescription Drug Take Back Day across the country this Saturday, April 28.

Medicare Requiring Hospitals to Post Prices Online

WEDNESDAY, April 25, 2018 -- U.S. hospitals will have to post their standard prices online and make it easier for patients to access their electronic medical records, Medicare officials said Tuesday.

Lonafarnib May Lower Mortality in Hutchinson-Gilford Progeria

WEDNESDAY, April 25, 2018 -- Lonafarnib monotherapy is associated with lower mortality among patients with Hutchinson-Gilford progeria syndrome (HGPS), according to a study published in the April 24 issue of the Journal of the American Medical Association.

Increase in HTN in Children Based on 2017 AAP Guidelines

WEDNESDAY, April 25, 2018 -- The prevalence and severity of high blood pressure (BP) in children have increased based on the 2017 American Academy of Pediatrics clinical practice guidelines, according to a study published online April 23 in JAMA Pediatrics.

Lupus Is a Leading Cause of Death in Young Women

WEDNESDAY, April 25, 2018 -- Systemic lupus erythematous (SLE) is among the top 20 leading causes of death in females between the ages of 5 and 64 years in the United States, according to a study published online April 18 in Arthritis & Rheumatology.

Aortic Stiffness, Concentric LV Remodeling Linked in T2DM

WEDNESDAY, April 25, 2018 -- For patients with type 2 diabetes, aortic stiffness is associated with concentric left ventricular (LV) remodeling, according to a study published online April 16 in Diabetes.

Exercise Intervention Doesn't Improve Walking Ability in PAD

TUESDAY, April 24, 2018 -- For patients with peripheral artery disease (PAD), a home-based exercise intervention does not improve walking ability over nine months compared with usual care, according to a study published in the April 24 issue of the Journal of the American Medical Association.

Ticagrelor + Aspirin Beneficial After Elective CABG

TUESDAY, April 24, 2018 -- For patients undergoing elective coronary artery bypass grafting (CABG), ticagrelor + aspirin is associated with significantly increased saphenous vein graft patency rates compared with aspirin alone, according to a study published in the April 24 issue of the Journal of the American Medical Association.

Electric Cars Safe With Cardiac Implantable Electronic Devices

MONDAY, April 23, 2018 -- Electric cars seem to be safe for patients with cardiac implantable electronic devices (CIEDs), and do not result in electromagnetic interference (EMI), according to a study published online April 24 in the Annals of Internal Medicine.

Patients Prefer Doctors Who Engage in Face-to-Face Visits

MONDAY, April 23, 2018 -- Patients prefer physicians who engage in face-to-face (F2F) clinic visits, rather than those using an examination room computer (ERC), according to a research letter published online April 19 in JAMA Oncology.

Controlling High Blood Pressure Could Prevent Dementia

MONDAY, April 23, 2018 -- Controlling high blood pressure in older African-Americans may prevent future dementia, according to a study published recently in the Journal of General Internal Medicine.

High FGF-23 Linked to Recurrent Cardiac Events After ACS

FRIDAY, April 20, 2018 -- Elevated fibroblast growth factor 23 (FGF-23) is associated with increased risk of recurrent major cardiovascular (CV) events in patients after an acute coronary syndrome (ACS), according to a study published online April 18 in JAMA Cardiology.

Systolic BP Increases at Rapid Rate Above 120 to 125 mm Hg

FRIDAY, April 20, 2018 -- After systolic blood pressure (BP) reaches 120 to 125 mm Hg, it increases at a relatively rapid rate toward overt hypertension, according to a study published online March 21 in JAMA Cardiology.

In LVSD, Diabetes Tied to Higher Risk of Heart Failure

FRIDAY, April 20, 2018 -- In patients with asymptomatic left ventricular systolic dysfunction, diabetes is associated with an increased risk of developing heart failure, according to a study published online April 6 in Diabetes Care.

Delayed Coronary Obstruction Rare After TAVR

THURSDAY, April 19, 2018 -- Delayed coronary obstruction (DCO) after transcatheter aortic valve replacement (TAVR) is a rare phenomenon but is associated with a high in-hospital mortality rate, according to a study published in the April 10 issue the Journal of the American College of Cardiology.

Number of Cigarettes Smoked Daily Tied to Stroke Risk

THURSDAY, April 19, 2018 -- There is a strong dose-response relationship between the number of cigarettes smoked daily and ischemic stroke risk among men younger than 50 years of age, according to a study published online April 19 in Stroke.

Stronger Link With Mortality for Ambulatory Versus Clinic BP

WEDNESDAY, April 18, 2018 -- Compared with clinic blood-pressure measurement, ambulatory blood-pressure measurement is more strongly associated with mortality, according to a study published in the April 18 issue of the New England Journal of Medicine.

Smartphone App May Up Medication Adherence in HTN

WEDNESDAY, April 18, 2018 -- Randomization to use of a smartphone app is associated with a small improvement in medication adherence but no change in systolic blood pressure among individuals with poorly controlled hypertension, according to a study published online April 16 in JAMA Internal Medicine.

Calcium Channel Blockers May Up Pancreatic Cancer Risk in Women

TUESDAY, April 17, 2018 -- Use of short-acting calcium channel blockers (CCBs) is associated with increased risk of pancreatic cancer in postmenopausal women, according to a study presented at the annual meeting of the American Association for Cancer Research, held from April 14 to 18 in Chicago.

Caffeine Does Not Appear to Be Linked to Risk of Arrhythmia

TUESDAY, April 17, 2018 -- Regular intake of coffee and tea does not appear to be associated with the risk of arrhythmia, according to a review published in the April 1 issue of JACC: Clinical Electrophysiology.

Social Worker-Led Intervention Beneficial in Heart Failure

TUESDAY, April 17, 2018 -- A social worker-led palliative care intervention seems beneficial for patients with advanced heart failure at high risk for mortality, according to a study published online April 11 in JAMA Cardiology.

Nut Consumption Associated With Reduced Risk of A-Fib

TUESDAY, April 17, 2018 -- Nut consumption is associated with reduced risk of atrial fibrillation, according to a study published online April 16 in Heart.

Recommendations Developed on Gender Equity in Medicine

MONDAY, April 16, 2018 -- In a position paper published online April 17 in the Annals of Internal Medicine, recommendations are provided aimed at addressing gender equity in physician compensation and career advancement opportunities.

Similar Outcomes for Transplant With Overdose-Death Donors

MONDAY, April 16, 2018 -- Transplantation of organs from overdose-death donors (ODDs) is associated with similar five-year patient survival and graft survival as organs from trauma-death donors (TDDs) and medical-death donors (MDDs), according to a study published online April 17 in the Annals of Internal Medicine.

Women Less Likely to Fill Post-MI Statin Prescription

MONDAY, April 16, 2018 -- Women are less likely than men to fill a prescription for high-intensity statins after hospitalization for myocardial infarction (MI), according to a study published in the April 24 issue of the Journal of the American College of Cardiology.

Cigarette Smoking a Risk Factor for Heart Failure in Blacks

MONDAY, April 16, 2018 -- Cigarette smoking is a risk factor for left ventricular (LV) hypertrophy, systolic dysfunction, and incident heart failure hospitalization in blacks, according to a study published online April 16 in Circulation.

Nonoptimized Drug Therapy Costs More Than $500 Billion Annually

MONDAY, April 16, 2018 -- The estimated annual cost of drug-related morbidity and mortality resulting from nonoptimized medication therapy is more than half a trillion dollars in the United States, according to a study published online March 26 in the Annals of Pharmacotherapy.

Negative Affect That Lingers Tied to Health 10 Years Later

FRIDAY, April 13, 2018 -- Negative affect that lingers is associated with worse physical health outcomes almost 10 years later, according to a study published online March 19 in Psychological Science.

Review: Lowest Mortality Risk Seen With ≤100 g Alcohol/Week

FRIDAY, April 13, 2018 -- For current alcohol drinkers, the threshold for the lowest risk of all-cause mortality is about 100 g/week, according to a review published in the April 14 issue of The Lancet.

Rapid Deployment Valve for Aortic Stenosis Ups Stroke Risk

FRIDAY, April 13, 2018 -- For patients with aortic valve stenosis, treatment with a rapid deployment valve (RDV) is associated with increased rates of new-onset pacemaker implantation and disabling stroke, compared with conventional biological valves (CBVs), according to a study published in the April 3 issue of the Journal of the American College of Cardiology.

Recent Years Saw Increase in Burden of Prior Authorization

THURSDAY, April 12, 2018 -- The burden of prior authorization (PA) has increased over the past five years, and 92 percent of physicians report associated delays in access to care, according to the results of a survey published by the American Medical Association (AMA).

CVD Burden Decreased From 1990 to 2016 Across U.S.

THURSDAY, April 12, 2018 -- From 1990 to 2016 there were decreases in cardiovascular disease (CVD) disability-adjusted life years (DALYs) in all states across the United States, according to a study published online April 11 in JAMA Cardiology.

Vascular Dysfunction Linked to Greater Symptoms of Menopause

THURSDAY, April 12, 2018 -- Menopause-related general somatic symptom frequency and severity are inversely associated with arterial stiffness and endothelial function among women across the stages of menopause, according to a study published online April 11 in Menopause.

Cigarette Price Hike Would Provide More Gains for the Poor

THURSDAY, April 12, 2018 -- An increase in the market prices of cigarettes would provide more health and financial gains to the poorest 20 percent of the population, according to a study published online April 11 in The BMJ.

Higher Mortality Risk Seen for 'Night Owls'

THURSDAY, April 12, 2018 -- Individuals with a later chronotype have increased mortality risk, according to a study published online April 12 in Chronobiology International.

Workplace Noise Exposure Affects Cardiovascular Risk Factors

THURSDAY, April 12, 2018 -- Hypertension, elevated cholesterol, and hearing difficulty are more prevalent among noise-exposed workers, according to a study published online March 14 in the American Journal of Industrial Medicine.

No Higher Cancer Risk Seen for Heart Failure Patients

THURSDAY, April 12, 2018 -- Heart failure is not associated with an increased risk of cancer, according to a study published in the April 10 issue of the Journal of the American College of Cardiology.

Declines Seen in Cardiovascular Risk Factors From 1990 to 2010

WEDNESDAY, April 11, 2018 -- Among adults aged 40 years and older, cardiovascular risk decreased in men from 1990 to 2010 and increased followed by a decrease in women over the same time period, according to a study published online March 22 in Aging Clinical and Experimental Research.

No Reduced CVD Risk for SBP <120 mm Hg in Type 2 Diabetes

WEDNESDAY, April 11, 2018 -- For patients with type 2 diabetes mellitus (T2DM), there is no reduction in cardiovascular disease (CVD) risk with achieved systolic blood pressure (SBP) of <120 mm Hg versus <130 or <140 mm Hg, according to a study published online March 28 in Diabetes Care.

Civilian Prehospital Tourniquets Linked to Reduction in Mortality

WEDNESDAY, April 11, 2018 -- Civilian prehospital tourniquet application is associated with a six-fold mortality reduction in patients with peripheral vascular injuries, according to a study published in the Journal of the American College of Surgeons.

Smoke Exposure Tied to Higher CV, Cerebrovascular ER Visits

WEDNESDAY, April 11, 2018 -- For all adults, and especially for those older than 65 years, smoke exposure is associated with cardiovascular and cerebrovascular emergency department visits, according to a study published online April 11 in the Journal of the American Heart Association.

Suggestions Offered to Reduce Physician Frustration With EHRs

TUESDAY, April 10, 2018 -- Changes can be implemented to help reduce physician frustration with electronic health records (EHRs), according to an article published in Medical Economics.

Considerable Differences in Burden of Disease at State Level

TUESDAY, April 10, 2018 -- There are considerable differences in the burden of disease at the state level, according to a study published in the April 10 issue of the Journal of the American Medical Association.

Metabolic Syndrome Common in Patients With Lupus

TUESDAY, April 10, 2018 -- As with the general population, metabolic syndrome (MetS) is common among patients with systemic lupus erythematosus (SLE), according to a study published online April 3 in the International Journal of Rheumatic Diseases.

Exercise Best Defense for Those at Genetic Risk for CVD

TUESDAY, April 10, 2018 -- Fitness and physical activity are tied to lower risk of incident cardiovascular disease in the general population and among individuals with elevated genetic risk for cardiovascular diseases, according to a study published online April 9 in Circulation.

Informal CVD Caregiving Costs Estimated at $61 Billion in 2015

MONDAY, April 9, 2018 -- The costs of informal caregiving for patients with cardiovascular disease (CVD) were estimated at $61 billion in 2015 and are set to more than double by 2035, according to a policy statement published online April 9 in Circulation.

Eating Pecans May Cut Risk of Cardiovascular Disease, Diabetes

FRIDAY, April 6, 2018 -- Eating pecans every day for four weeks improves certain markers of cardiometabolic disease risk, according to a study published online March 11 in Nutrients.

Interns' Schedule Takes Toll on Sleep, Physical Activity, Mood

FRIDAY, April 6, 2018 -- New interns' intense and changing schedules take a toll on sleep, activity, and mood, according to a study published online March 14 in the Journal of General Internal Medicine.

Small Employers Often Don't Provide Tobacco Cessation Help

FRIDAY, April 6, 2018 -- Nearly half of small employers using tobacco surcharges do not provide tobacco cessation wellness programs, according to a report published in the March issue of Health Affairs.

High-Intensity Exercise Harmful in Arrhythmogenic Cardiomyopathy

FRIDAY, April 6, 2018 -- High-intensity exercise in an independent marker for ventricular arrhythmia (VA) in arrhythmogenic cardiomyopathy (AC), according to a study published online March 28 in JACC: Clinical Electrophysiology.

Myocarditis Rare Side Effect of Immune Checkpoint Inhibitors

FRIDAY, April 6, 2018 -- Myocarditis in patients treated with immune checkpoint inhibitors (ICIs) may be more common than previously thought, according to a study published online March 19 in the Journal of the American College of Cardiology.

ACA Marketplaces Expand Coverage for Chronically Ill

THURSDAY, April 5, 2018 -- The Affordable Care Act's Marketplaces covered a disproportionate share of non-elderly adults with high health care risks in the 2014 to 2015 time period, according to a study published in the April issue of Health Affairs.

Online Doc Reviews Don't Reflect Patient Satisfaction Surveys

THURSDAY, April 5, 2018 -- Online physician reviews do not reflect patient satisfaction surveys (PSSs), according to a study published in the April issue of the Mayo Clinic Proceedings.

Coffee Consumption Cuts Coronary Artery Calcification

THURSDAY, April 5, 2018 -- There is an inverse association between coffee consumption and coronary artery calcium (CAC), especially among never smokers, according to a study published online March 24 in the Journal of the American Heart Association.

New Map Improves Emergency, Trauma Care Referrals

THURSDAY, April 5, 2018 -- The Pittsburgh Atlas provides a new framework for emergency and trauma care regional referrals in the United States, according to a study published online March 28 in the Annals of Emergency Medicine.

Smoking Status Associated With Poor Diet Quality

THURSDAY, April 5, 2018 -- Smokers have lower quality diets than former smokers and nonsmokers, according to a study published online April 4 in BMC Public Health.

Medicare Program Narrows Racial Disparities in Readmissions

WEDNESDAY, April 4, 2018 -- Medicare's Hospital Readmissions Reduction Program is associated with a narrowing of racial disparities in hospital readmissions, according to a study published in the April issue of Health Affairs.

Eating Veggies Found to Protect Against Atherosclerosis in Women

WEDNESDAY, April 4, 2018 -- Eating more vegetables may prevent subclinical atherosclerosis in elderly women, according to a study published online April 4 in the Journal of the American Heart Association.

Variations Identified in Free-Text Directions in E-Prescriptions

WEDNESDAY, April 4, 2018 -- There is considerable variation in the quality of free-text patient directions (Sig) in electronic prescriptions (e-prescriptions), according to a study published online April 2 in the Journal of Managed Care & Specialty Pharmacy.

Metabolic Abnormalities Seen in Testicular Cancer Survivors

WEDNESDAY, April 4, 2018 -- Testicular cancer survivors (TCS) have metabolic abnormalities characterized by hypertension and increased low-density lipoprotein (LDL) and total cholesterol, according to a study published in the March 1 issue of the Journal of the National Comprehensive Cancer Network.

Outcomes-Based Pricing Doesn't Cut Costs of PCSK9 Inhibitors

TUESDAY, April 3, 2018 -- Outcomes-based pricing does not reduce the costs of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, according to a research letter published online April 3 in the Annals of Internal Medicine.

Preconception Blood Pressure Tied to Risk of Pregnancy Loss

TUESDAY, April 3, 2018 -- In healthy women, preconception blood pressure is associated with miscarriage, according to a study published online April 2 in Hypertension.

Genotype-Guided Antiplatelet Therapy Feasible, Effective

TUESDAY, April 3, 2018 -- Using CYP2C19 genotype-guided dual antiplatelet therapy (DAPT) selection is feasible in a real-world setting, although frequency of testing may be difficult to maintain, according to a study published online April 3 in Circulation: Genomic and Precision Medicine.

Infant Heart Defects May Be Early Marker of Future CVD in Mothers

MONDAY, April 2, 2018 -- Women whose infants have congenital heart defects have an increased risk of cardiovascular hospitalization later in life, according to a study published online April 2 in Circulation.

Grief Symptoms Similar in Donor vs Non-Donor Decision Families

MONDAY, April 2, 2018 -- Perceptions of the organ donation experience vary between relatives who decide to donate their relative's organs and those who do not, but the decision does not appear to be associated with subsequent grief symptoms, according to a study published online March 19 in the American Journal of Respiratory and Critical Care Medicine.