News, Photos & Announcements:

20

The search for the Holy Grail in cardiology has been the ability to obtain high quality pictures of the coronary arteries without the need to enter the body. CAT scans are specialized x-rays that have been used to obtain images of many body parts. The ability of CAT scans to obtain pictures of the heart has been limited by one unique property of the heart that distinguishes it from any other organ in the body…it continuously moves! The latest generation of high speed x-ray imaging systems and computer processors now enable exactly this. Using “multiple slice, multiple detector” technology, external images of the beating heart of sufficiently high quality to be comparable to coronary angiograms can now be obtained. The latest generations of scanners obtain coronary CT angiograms (CCTA) that reliably show the level of plaque inside coronary arteries just like a cardiac catheterization, and so much more. The CCTA does all of this in a painless, 14 second examination that requires the patient to simply lie inside a hollow chamber and briefly hold their breath. The greatest value of the CCTA examinations is to exclude, or “rule-out” CHD. In patients with suspected coronary heart problems, the CCTA has nearly 100% accuracy in the ability to detect any level of plaque. Since nearly one out of three patients in the U.S who have a cardiac catheterization turn out to not have any serious blockages, a CCTA potentially could eliminate many of these unnecessary invasive catheterizations.

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01

A European Collaborative study has found that individuals who lived in areas where they breathed in large concentrations of particles of polluted air over a long period had a marked increase in the risk of having heart attacks. The study further supports previous research that environmental pollutants can contribute to the risk of heart disease. The ESCAPE trial found that just a 5ug/m3 level increase in pollutants corresponded with a 13% increased risk of heart events. This risk was independent of the effects of other heart risk factors, such as age, sex, smoking and socioeconomic status. Take an increasing level of individual responsibility to modify those heart risk factors that are under your direct control. Avoid tobacco exposure, exhaust fumes and maintain a healthy lifestyle for yourself. Take a pro-active role in evaluating and modifying your heart risk in partnership with your health care provider.

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18
Last week, the American Heart Association and the American College of Cardiology issued the long-awaited update to the U.S. national guidelines for the management of blood cholesterol disorders. These guidelines are considered by many physicians to be the definitive approach by which they should treat their patients. The new guidelines supplant the last set that was issued back in 2001. Although the new guidelines are simpler to follow and provide for more personalized decision making in cholesterol treatment, they also significantly increase the number of patients who are recommended to receive statins. Make sure you engage in a discussion with your doctor about how these guidelines apply to you, and discuss the issues specific to your health that affect the risks and benefits of statin therapy.

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03
Living in New York City has some fabulous perks; food, entertainment, nightlife, culture, but a heart healthy lifestyle does not fall high on most people’s lists. However, data presented at this week’s Canadian Cardiovascular Congress in Montreal show that a decade of health policies and health-promotion messages in New York City have pushed heart disease rates downward faster there than they have elsewhere in the U.S. Since 2002, the life expectancy in New York City has risen by 36 months, compared to an average increase of 21.6 months in the rest of the country. Over half of this increase is attributable to a lowered risk of fatal cardiovascular diseases.

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20
This week, Regeneron and Sanofi pharmaceuticals announced the results of the Odyssey Mono trial that looked at the effectiveness of their new cholesterol reducing agent, Alirocumab. Tested in 103 patients with high cholesterol and moderate risk factors for coronary heart disease (CHD), the drug cut bad cholesterol (LDL-C) in half over a course of 24 weeks. Alirocumab is the first drug to complete a Phase 3 clinical trial looking at safety and efficacy in an exciting new class of cholesterol reducing drugs called PCSK9 inhibitors. Although the results of such early clinical trials are encouraging, no trial has yet reported on clinical outcomes, such as a reduction in the rate of heart attacks, strokes or mortality. These would be the next phase of trials evaluating PCSK9 inhibitors, and would likely take a minimum of 5 more years. Stay tuned, as the story about these new cholesterol lowering therapies is still very much a work in progress. In the meantime, if you already have CHD or are at high risk, make sure you discuss with your doctor what your LDL-C goal is, and how to achieve it. If you don’t have CHD, start your heart disease prevention program now!

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07
This week at the annual Heart Failure Society of America meetings in Orlando, investigators from Ohio State University reported that sleep-disordered breathing identified in patients admitted to the hospital with acute decompensated congestive heart failure (CHF) predicted elevated cardiac readmission risk and an increased mortality rate. Sleep apnea is estimated to occur in 20 million Americans. It is strongly linked to obesity, and is also known to increase the risk of hypertension, stroke, heart arrhythmias and MI. This is likely mediated through the effects of increased adrenalin that is stimulated by a lack of oxygen in the blood during periods of apnea. If you have CHF, are obese, or have disordered sleep patterns, ask your health care provider to put you through an evaluation for sleep disorders and sleep apnea. If you are found to have this, the treatment will not only improve the quality of your sleep and life, but just might save your life!

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14
Last week, the pharmaceutical giant Boehringer Ingelheim filed an application with the FDA for approval of its blood thinner Pradaxa for use in patients who have blood clots in the legs, known as deep vein thrombosis (DVT) and blood clots in the lungs, known as pulmonary embolism (PE). This extends the already approved indication for Pradaxa in patients with the heart arrhythmia known as atrial fibrillation. Patients now have the choice of four anticoagulant blood thinners; warfarin, Pradaxa, Xarelto and Eliquis as well as four antiplatelet blood thinners; aspirin, clopidrogel (Plavix), Effient and Brilinta. Discuss the risks and benefits of these medications with your doctor not only when starting on them, but periodically while taking them as well, since the proper and safe use of antiplatelet and anticoagulant blood thinners can be complicated.

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24
Both obesity and type-2 diabetes are serious public health issues. More than 30% of the U.S. population is obese, and 15% is diabetic. A diagnosis of either reduces life expectancy by 10 years. Both are conventionally treated with lifestyle modifications and medications to achieve weight loss and control of blood sugar, blood pressure and lipids. However, in over 90% of patients the results are not maintained. In the Diabetes Surgery Study (DSS), investigators studied 120 middle-aged diabetic patients who were moderately obese (Body Mass Index; BMI 30-40 kg/m2) and assigned half to receive either conventional diet, exercise and medication therapy and the other half to conventional therapy combined with a weight loss surgical procedure called a Roux-en-Y gastric bypass. After 12 months, 49% of the group who had the gastric bypass surgery achieved and maintained the desired level of blood pressure (BP), diabetes and lipid control. In the group receiving conventional therapy and no surgery, only 19% achieved and maintained the desired BP, diabetes and lipid control. These observations suggest that bariatric surgery may be better than standard therapy in obese diabetics to achieve better diabetic, BP, lipid and weight control. However, the findings are based upon only one years’ worth of observation. Beyond this time, it is unknown which group will do better.

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04
It has long been known that the risk of heart attacks and sudden cardiac death increases significantly in communities immediately following the acute stress that accompanies natural disasters like hurricanes, earthquakes and tsunamis. Two recently published studies now indicate that the increased cardiovascular risks persist for months to years in such communities. In a study of nearly 70,000 patients from Tulane Medical Center in New Orleans, investigators found that hospitalizations for heart attacks have tripled since Hurricane Katrina ravaged New Orleans in 2005, and that the high rate of heart attacks persists even 6 years later. Investigators from Japan reported that following the massive earthquake in 2011, the incidence of heart attacks doubled in the area most severely damaged by the earthquake. If you or family members live in an area affected by a natural disaster, do as much as you can to maintain your healthy lifestyles and continuity in your medical care. While the immediate effects of these natural disasters in a community may feel heartbreaking, these disasters themselves have the capability to break hearts long after the hurricane moves out to sea or the ground stops shaking.

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20
In a study of patients at a single U.S. military center, routinely using non-invasive coronary CAT scans in the evaluation of patients who presented with chest pain reduced the need to perform invasive cardiac catheterizations by 62%. The newest generation of CAT scanners, called “multislice” scanners can obtain X-rays at very high speed and in very thin virtual layers or “slices” of the heart. Recent studies indicate that multislice cardiac CAT scan examinations have accuracy rates for detecting coronary heart disease (CHD) that exceed 90%. If you have chest pain, talk to your cardiologist about whether you might be a candidate for using coronary CAT scan imaging to determine if you have CHD.

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21
Actor James Gandolfini, best known for his notorious Tony Soprano character from the HBO serial “The Sopranos” suffered a heart attack this past Wednesday while on holiday in Rome. Within 40 minutes of receiving medical attention, he was pronounced dead. Mr. Gandolfini died of sudden cardiac death. SCD occurs in over 360,000 individuals annually in the U.D. It happens without warning, and often without any preceding symptoms. If you have risk factors for heart disease, like obesity, high cholesterol, diabetes, family history, hypertension, smoking, to name only a few, you need to see your doctor for screening examinations. Do not delay evaluating and managing your heart risk factors, because in many instances, your first symptom of heart disease may also be your last… in the form of sudden cardiac death!

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07
On May 3, the U.S. FDA approved the release of the fixed-dose combination cholesterol medication, Liptruzet for cholesterol reduction. The drug is a combination of two already available cholesterol lowering drugs, Zetia and Lipitor. At maximum doses, the drug will reduce the LDL-C (bad cholesterol) by 61%. However, one could get the same LDL-C lowering by taking both components of the drug separately as two pills, and get even more LDL-C lowering by using the more potent statin, Crestor (rosuvastatin) in combination with Zetia. Using the maximum dose of the generic Lipitor by itself will reduce LDL-C levels by 54%. For most people, it is unlikely that the extra 7% LDL-C lowering provided by Liptruzet is worth it. Furthermore, there are almost no studies that have shown that Zetia, despite its ability to assist in cholesterol lowering has any benefit in lowering the risk of heart attacks, strokes, atherosclerosis or death. 

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18
Hysterectomy is a common surgical procedure. Nearly 600,000 are performed each year in the U.S., with over 20 million women already having undergone the procedure. However, one concern among experts who study heart disease in women has been the theoretical risk that hysterectomy may accelerate the future risk of coronary heart disease (CHD) in women who had the procedure before menopause. The findings of a study from the National Institutes of Health, and published in this month’s Journal of the American College of Cardiology indicate that heart risk is not adversely increased following hysterectomy.

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07
This month, researchers in the U.K reported on their experience in using a combination of medical history, a focused physical examination and a 12-lead ECG in screening over 15,000 athletes between the ages of 14-35 years of age. The ECG alone found abnormalities in 1,183 athletes, of whom 67 were later diagnosed with serious heart problems. The investigators concluded that had ECG’s not been routinely performed, all of these athletes would have remained with undetected heart disease and put themselves at risk for sudden cardiac death by participation in sports. This study further supports the recommendations for routine ECG screenings in young athletes by the International Olympic Committee, and the European and Japanese Cardiology Societies. However, such screenings are neither required nor considered standard of care in the United States. The primary reason for this is that the costs associated with routine screenings are considered prohibitive. As the evidence supporting the value of ECG’s in screening athletes’ mounts, and more young athletes die needlessly, the debate about the cost-effectiveness of ECG screening starts to ring even more hollow.

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27
In 2010, Coca Cola used the slogan “Life Starts Here!” to promote its soft drink brands. A recent study of 350,000 individuals suggests that consumption of soft drink sodas significantly increases the risk of diabetes. The study, known as the EPIC trial (European Prospective Investigation into Cancer and Nutrition) evaluated the association between the consumption of sweet beverages and type 2 diabetes. The results showed that consumption of each 12-oz sugar-sweetened soft drink per day increased the risk of diabetes by 18%. Even among consumers of artificially sweetened soft drinks, the risk of diabetes was increased. Consumption of juices and nectars was not associated with developing diabetes. When it comes to beverages, the healthy choice appears to be The Real Thing…and I don’t mean the variety promoted by Coca Cola.

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18
Your mother told you to eat your vegetables. You resisted, and if you are like me, you especially hated beets. Now a study from the London School of Medicine and Dentistry provides strong evidence that many vegetables and especially beets are potent ways to naturally lower blood pressure. In the study, reported in the April 15 issue of the medical journal, Hypertension, researchers found in both an animal model of hypertension as well as in patients with high blood pressure who were not taking medications to treat hypertension, consuming small quantities of beet juice was highly effective in lowering blood pressure. So, for the purposes of naturally lowering your blood pressure and reducing your risk of heart disease and stroke, do what your mother told you, eat your vegetables, and especially your beets!

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06
Patients with the rheumatoid arthritis (RA) have significantly greater aortic wall inflammation than do patients with established coronary heart disease (CHD). Using PET scans of the aortic wall, researchers from NYU found that aortic wall inflammation indexes were on average 20-30% higher in patients with RA who did not have CHD than in patients without RA but who had known CHD. The finding led investigators to conclude that RA patients are at a very high risk for atherosclerosis by virtue of increased localized inflammation in blood vessels.

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28
A recent study presented at an American Heart Association symposium found the fitness habits of health care providers; physicians, nurses, pharmacists as well as nursing and medical students were strongly related to the amount of fitness and health counseling they gave to their patients. These data confirm and add to previous reports that have shown that patients are much more likely to accept and adopt healthy lifestyles if their doctors also exhibit healthy lifestyles.

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20
A new study from Italy has found that individuals who have partial blockages of the carotid artery that continue to worsen over time, even in the absence of any symptoms are at a much higher risk of having a stroke than those who have stable levels of plaque that remain static. Using serial carotid ultrasound examinations, the researchers found that subjects in whom the degree of blockage remained constant had a stroke risk of only 2.3%. However, in subjects who showed even mild increases in the level of plaque, over half experienced either a TIA or stroke within 4 years, with 27% going on to develop a disabling stroke. This information provides strong evidence that even those patients who have no symptoms, but have increasing levels of carotid plaque will benefit from procedures to restore normal blood supply in the carotid arteries.

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14
A study of nearly 15,000 male U.S. physicians conducted at Harvard Medical School has concluded that the routine use of multivitamin supplements is no more effective than placebo in preventing heart disease. The study, termed the Physicians Health Study II, was reported in the on-line December issue of the Journal of the American Medical Association. The study followed the subjects from 1997 through 2011, for an average of 11 years per subject. Cardiac events in all groups were tabulated as the occurrence of a stroke, heart attack or death due to heart disease. The group receiving the multivitamins experienced 11.0 events per 1000 subjects compared to 10.8 events per 1000 subjects in the placebo group. The message here is that if you already follow a healthy diet, there is no reason to take a multivitamin supplement.

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05
Dr. Sheikh has been invited to present his medical research at the 2013 International Cardiology Symposium to be held in Dubai, U.A.E. 

The presentation is entitled: "A personalized care approach is superior to usual care for the secondary prevention of cardiovascular disease events in a managed care environment." 

The Symposium is to be held from between 16-18 May 2013. Its scientific program is supported by various national and international societies: the Emirates Cardiac Society, the Brazilian Society of Cardiology, and the European Society of Cardiology, with the IAS (International Society of Atherosclerosis) as co-sponsor of the symposium.

The website for the symposium is: http://www.ics2013.com/

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04
Biomedical engineers from the University of California, San Diego and biotechnology firm Ventrix, Inc. reported in the latest issue of Science Translational Medicine of their success in an animal model to regenerate damaged heart tissue. Using a hydrogel made from the heart’s own connective tissue, the researchers injected a liquid form of the substance into the hearts of pigs that had been damaged in an experimental model to simulate the damage that occurs in a heart attack. Those pigs receiving the gel showed significantly improved heart function compared to the pigs receiving placebo injections.

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25

Dr. Sheikh is featured in the February/March, 2013 issue of Space Coast Medicine & Active Living. On pages 98-100, Dr. Sheikh discusses lipids and the value of having a lipid expert, otherwise known as a lipidologist provide an opinion about an individual's heart risk, and what can be done to further lower that risk. Also featured in the same issue are articles on pages 112-113 about emotional stress and heart disease, as well as an overview of Dr. Sheikh's new heart wellness book, "Don't Let Your Heart Attack!" on page 32.

Go to the following link and search for the page numbers as above:

http://trendmag2.trendoffset.com/publication/?i=146447.

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24
Heart attacks and strokes are a result of atherosclerosis, the process by which cholesterol deposits gradually narrow the arteries providing blood to the heart and brain. However, in nearly all instances, it is a blood clot caused by circulating blood platelets that leads to the acute event. For over 100 years aspirin was the only anti-platelet medication available. The drug Plavix was found to be superior to just aspirin alone over 20 years ago in preventing and treating heart attacks and strokes. Now, in the last five years, two new drugs, known as “super” aspirins have been found to be better than Plavix in treating patients who are either on the verge of, or are actually experiencing a heart attack. First Effient and now Brilinta have been found to further lower the risk of recurrent heart attacks, strokes and death in such patients. Both new drugs come with significant bleeding risks, and require careful monitoring and supervision, but represent a further advance in improving outcomes in critically ill heart patients.

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17
Heart healthy diets have long emphasized reducing bad fats found in cholesterol, trans-fats and saturated fats, and replacing with them with healthier mono and polyunsaturated fats. A new study in the February 5 issue of the British Medical Journal reports that even among the presumed heart-healthy polyunsaturated fats, those that contain the omega-6 variety of fatty acids may actually increase the risk of heart attacks, strokes and death. When following a low fat diet, emphasize the use of omega-3 fatty acids found in fish oils and the omega-9 fatty acids found in olive oil and avocados. Avoid the use of supplements, margarines and commonly used cooking oils that are high in the content of the omega-6 Linoleic acid.

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10
Daily use of aspirin is not only a common, but also a proven therapy for patients who have coronary heart disease (CHD). Now a new study from Sweden indicates that if heart patients stop taking aspirin for more than one week, their risk of heart attacks, strokes and death increases significantly. The study was conducted in 118 patients who had aspirin either permanently stopped or temporarily interrupted because of bleeding stomach ulcers. Among the patients who were on aspirin for CHD, the risk of heart attack, stroke and death within the first 6 months was 6.8-times higher if they had their aspirin permanently stopped than if they had aspirin only interrupted but later re-started.

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08
Dr. Sheikh was an invited speaker at the 10th Annual Health First Cardiology Symposium. The symposium was held on February 8, 2013 at the Hilton Rialto Conference Center in Melbourne, Fl. The audience of over 200 Health First Associates working in the area of Cardiovascular Services heard Dr, Sheikh's lecture on "Reversal of Heart Disease: Myth or Reality?"

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03
Kynamro (mipomersen sodium) becomes the second new, highly potent cholesterol lowering drug to be approved by the FDA in as many months for treatment of the rare genetic condition, Homozygous Familial Hyperlipidemia (HoFH). In a randomized, double-blind, placebo-controlled, multi-center trial sponsored by the drug’s manufacturer, Sanofi, Kynamro administered by weekly, subcutaneous injection in patients with HoFH reduced LDL-C levels by an additional 25%. The study did not look at clinical outcomes such as occurrence of heart attacks and strokes. Kynamro’s will be an orphan drug based upon the scarcity of HoFH, restricted prescribing because of its potential for serious toxicity, need for administration through weekly injections and an estimated annual cost of therapy of about $200,000.

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27
The Copenhagen City Heart Study of 11,000 subjects followed for 35 years found that four physical signs of aging correspond with an increased risk of heart attacks, strokes and atherosclerosis. Specifically, the occurrence of xanthalesma (yellowish raised cholesterol deposits near the eyelid), an earlobe crease, premature crown-top baldness and a prematurely receding hairline all correlated with an increased risk of heart disease. Having just one of the visible signs of aging increased the risk of heart attack and stroke by 20% compared to individuals who had none of the four signs. Having all four signs of aging increased the risk of heart attack and strokes by 60%. The findings of this study indicate that patients and their health care providers should take time to look at the skin and their overall appearance to see if there are signs of premature aging. If this is the case, then that individual should be more closely evaluated by additional testing for the presence of heart disease.

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21
A U.S. governmental behavioral health agency released a report that concluded that energy drinks constitute a “continuing public health concern.” The report cited data that between 2005 and 2011, visits to U.S ER’s increased by more than 10-fold due to medical problems associated with consumption of popular energy drinks like Monster, Red Bull, 5-hour energy, to name just a few. The high content of caffeine and like-stimulants such as Guarana were felt to be responsible. Among the reported medical problems were seizures, heart arrhythmias, heart attacks, strokes, high blood pressure, insomnia, headaches, nervousness, mania and even death.

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12
A recent study from Case Western Reserve University has found that oral vitamin D supplementation in patients with congestive heart failure (CHF) significantly reduces the levels of the hormone aldosterone. Reduced levels of aldosterone are associated with reduced mortality rates in CHF patients. A recent review of nearly 1500 small clinical trials concluded that Vitamin D deficiency in the general population is more prevalent than previously thought. Vitamin D supplementation may be beneficial to reduce the risk of hypertension, stroke, heart attack, cancer and premature death. Consider taking an over-the-counter vitamin D supplement of 1000-2000 IU/day if you are over the age of 50.

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06
After 4 years the 30,000 subject Heart Protection Study 2-Treatment of HDL Cholesterol to Reduce the Incidence of Cardiovascular Events (HPS2-THRIVE) trial was halted after analysis of results showed no benefit to Merck’s HDL cholesterol (HDL-C) raising drug Tredaptive. The medication was a combination pill of an extended release form of Niacin and Laropiprant, an inhibitor of prostaglandins that was added to the pill to reduce the common side effect of skin flushing and itching associated with Niacin use. The results of HPS-THRIVE come on the heels of the recent results from the AIM-HIGH trial also using extended release Niacin as well as several trials using a class of drugs known as CETP inhibitors, which also failed to show a benefit of raising HDL-C in reducing heart risk.

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29
Juxtapid, the first of a new class of potent cholesterol reducing medications was approved by the FDA for release to patients in the U.S. The drug, whose chemical name is lomitapide, is made by Aegerion Pharmaceuticals. The drug is approved for use by patients who have the rare genetic condition Homozygous Familial Hypercholesterolemia (HoFH).

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23
Florida Today newspaper announced in its December 23, 2012 edition of the release of the book, “Don’t Let Your Heart Attack!” The book is authored by local cardiologist K H Sheikh, MD.

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22
The results of a meta-analysis of nearly 120,000 patients by Columbia University researchers indicates that one’s perception of their level of stress and how they cope with stress affects the likelihood they will have a heart attack or die from coronary heart disease (CHD). Individuals who scored as having a high perception of stress in their lives were at a 27% higher risk of dying or having a heart attack compared to low stress individuals. This magnitude of risk is equivalent to having a 50 mg/dL increase in LDL (bad) cholesterol or smoking five more cigarettes per day. By being aware of how you handle and cope with stress, you can lower your risk to develop CHD or die as a result of CHD. In our busy and hectic lives, we should all consider stress management an integral part of our individual wellness plans.

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16

The U.S. Attorney’s Office in Pittsburgh, Pa. reached a settlement with Westmoreland Hospital in Greensburg, Pa. to repay the federal government nearly $2 million in Medicare payments it received for unnecessary heart angioplasty procedures. The case is another in a familiar line of fraudulent, unnecessary and inappropriate heart angioplasty procedures that have recently become public. In August, 2012 an appeals court in Louisiana upheld the conviction of cardiologist Mehmood Patel for 51 counts of health care fraud related to unnecessary angioplasty procedures. In 2009, Baltimore cardiologist Mark Midei, who earned a seven-figure salary, resigned from St. Joseph’s Medical Center when an investigation revealed that he had falsified records and performed unnecessary angioplasty procedures in roughly 600 patients.

Nearly one million coronary angioplasty and stent procedures are done each year in the U.S. to treat coronary artery blockages. Coronary artery stents are the most common medical device used in the U.S. A recent clinical study published in the Journal of the American Medical Association found that nearly half of all of these procedures, when done in non-emergency situations were unnecessary.

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10
Brevard Business News announced in its December 10, 2012 edition of the release of the book, “Don’t Let Your Heart Attack!” The book is authored by local cardiologist K H Sheikh, MD.

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09
In November, Amgen and Pfizer both released favorable data from preliminary trials using a novel set of compounds called PCSK9 inhibitors to reduce LDL-C (also known as bad cholesterol). The compounds are antibodies that block the effects of a protein made by the PCSK9 gene. By blocking the effects of the PCSK9 protein, the activity of the liver receptors that remove LDL-C is increased, which helps to dramatically lower blood LDL-C levels.

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02
A 10 year study of over 10,000 men with cholesterol and lipid disorders, who did not have pre-existing heart disease, has found that the risk of dying among the fittest participants was 50% lower than among those in the least fit group. The study is the first to show a clear relationship between the beneficial effects of exercise and the risk of dying in such a large group of patients. It was conducted at the VA medical centers in Palo Alto, CA and Washington DC, and is reported in the British journal, Lancet.

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25
A new study suggests that an increased heart risk can be added to the list of the harmful effects of losing a job. The study published in the November 19, 2012 on-line edition of the Archives of Internal Medicine by Duke University researchers indicates that being unemployed carries a 35% higher risk of having a heart attack, also known as a myocardial infarction (MI) than being employed.

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16

Another prominent celebrity died prematurely of sudden cardiac death. Davy Jones, who was the lead singer for the popular rock group in the 1960’s and 1970’s died at the age of 66. An autopsy confirmed he had a heart attack caused by atherosclerosis, leading to a blockage of cholesterol and blood clot in his coronary arteries. This led to a sudden deprivation of blood supply to the heart muscle leading to a a catastrophic arrhythmia, called ventricular fibrillation.

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