traciklein

Traci Klein @traciklein

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Mayo

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USA

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2 days ago by @traciklein · View  

Research says: Patients with cancer history experiencing severe heart attacks benefit from cardiac treatment

heart shape icons on electronic background with broken red heart in middleROCHESTER, Minn. – One in 10 patients who come to the hospital with the most severe type of heart attack have a history of cancer, showing that this is an emerging subgroup of heart patients, according to Mayo Clinic research published in Mayo Clinic Proceedings. In addition, the study found that these patients have a three times higher risk of noncardiac death. Meanwhile, their risk of cardiac death is not higher ― both at the time of their acute heart attack and over long-term follow-up.

Researchers conducted a retrospective cohort study of 2,346 patients seen at Mayo Clinic’s Rochester campus for an ST-elevation myocardial infarction ― the most severe acute heart attack. The retrospective covered a 10-year timeframe, beginning in 2000, when the newest and current types of stents were introduced into clinical practice. The patients were followed for acute and long-term outcomes for an average of six years.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, [email protected]

“We’ve watched cancer survivorship increase over the past 2½ decades, which is wonderful, but it has led to new challenges, such as handling of downstream illnesses and side effects to an extent never encountered before,” says Joerg Herrmann, M.D., senior author and interventional cardiologist at Mayo Clinic. “In particular, as cardiologists, we wanted to know if cancer and its therapies left these patients debilitated from a cardiovascular disease standpoint.”

Other study findings are:

  • Patients with a history of cancer arrived at the hospital more frequently with cardiogenic shock, where the heart suddenly cannot pump enough blood. In addition, they more often received intra-aortic balloon pump therapy, a device inserted to help the heart pump blood, and possibly indicating a reduced cardiac reserve.
  • Patients with a history of cancer, despite arriving to the hospital sicker, do not have a higher cardiac death rate. “This indicates that these patients receive the same, if not greater, benefit from angioplasty for an acute heart attack,” Dr. Herrmann says.
  • Patients with a history of cancer have a significantly higher possibility of dying in the hospital for reasons unrelated to the heart, despite arriving at the hospital with an acute heart attack.
  • Patients diagnosed within the six months before the heart attack had the highest (sevenfold increased) risk of death in the hospital following angioplasty. The reason is not clear, Dr. Herrmann says.
  • Patients with a history of cancer have a significantly higher risk of being hospitalized for heart failure during follow-up. But, with optimal medical treatment, there is no increased risk of dying from heart disease. These patients eventually die from their cancer disease, researchers found.

“This study supports the importance of cardiologists and oncologists working together to care for these patients,” Dr. Herrmann says. “Clearly, our goal is that the cancer patients of today do not become the cardiac patients of the future and, if they do, that we comprehensively see them through.”

This concept of care, which has become known as “cardio-oncology,” is an emerging medical discipline.

Mayo Clinic co-authors are:

  • Feilong Wang, M.D.
  • Rajiv Gulati, M.D., Ph.D.
  • Ryan Lennon
  • Bradley R. Lewis
  • Jae Yoon Park, M.D.
  • Gurpreet Sandhu, M.D., Ph.D.
  • Scott Wright, M.D.
  • Amir Lerman, M.D.

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About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 80 years and has a circulation of 130,000. Articles are available at http://www.mayoclinicproceedings.org/.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or http://newsnetwork.mayoclinic.org/.

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Mon, Oct 31 at 8:37am EST by @traciklein · View  

Sudden cardiac death of teen reminds physicians of promises, challenges of precision medicine

heart shape icons on electronic background with broken red heart in middleROCHESTER, Minn. — The sudden death of a 13-year-old boy resulted in more than 20 relatives to be incorrectly diagnosed as having a potentially lethal heart rhythm condition. This erroneous diagnosis occurred as a result of inappropriate use of genetic testing and incorrect interpretation of genetic test results, according to Mayo Clinic research published in Mayo Clinic Proceedings.

This case highlights the potential danger of genetic testing when it is used incorrectly and the great need to not only use this powerful tool carefully and wisely but to scrutinize the results with great caution, says senior author Michael J. Ackerman, M.D., Ph.D., genetic cardiologist and director of Mayo Clinic’s Windland Smith Rice Sudden Death Genomics Laboratory. “While the technological advances in genetic sequencing have been exponential, our ability to interpret the results has not kept pace,” he says.

Following the boy’s death, family members were diagnosed with long QT syndrome, an inherited heart rhythm condition that potentially can cause fast and chaotic heartbeats. In some cases, it can cause sudden cardiac death. People can be born with a genetic mutation that puts them at risk of long QT syndrome. As a result, the boy’s brother prophylactically received an implantable cardioverter defibrillator, which can stop a potentially fatal arrhythmia. Specific genetic testing was performed throughout the father’s side of the family, leading to the eventual, but incorrect, diagnosis of long QT syndrome in more than 20 family members, Dr. Ackerman says.

The family then traveled to Mayo Clinic for a second opinion. During the course of their initial clinical evaluations, Dr. Ackerman became skeptical quickly of their previous diagnosis. Over the years, 40 percent of the patients who came to Mayo Clinic with the diagnosis of long QT syndrome left without the diagnosis, with the vast majority reclassified as normal.

“This family’s case appeared to be another case of mistaken identity with wrong conclusions being rendered to the data ascertained, especially the genetic test results,” he says. “In fact, none of the relatives who sought a second opinion at Mayo Clinic had personal symptoms of long QT syndrome, and none exhibited any electrocardiographic evidence of long QT syndrome at rest or with treadmill stress testing.” Since receiving the implantable cardioverter-defibrillator, the boy’s brother has had two inappropriate shocks delivered.

Then, with this clinical doubt raised, Dr. Ackerman and co-investigators worked to discover the true reason behind the boy’s death. The research team used the molecular autopsy that was pioneered by Dr. Ackerman and his team. First performed in the late 1990s, the molecular autopsy has advanced to what Ackerman refers to as “the whole-exome molecular autopsy coupled with genomic triangulation.” This strategy “provided closure and clarity” for the family, he says. “We discovered that the boy died tragically from an abnormal heart muscle condition caused by an entirely different genetic defect – unrelated to long QT syndrome – that was confined to only the sudden death victim,” Dr. Ackerman says.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-284-5005, [email protected]

“This family study highlights just how important it is to get things right on the first attempt, as it takes a tremendous amount of time, energy and money to reverse course and do it over again. It also depicts exactly the wrong way of using genetic testing and also precisely the right way of using and interpreting genetic testing. Ultimately, the clinician’s long-standing role to meticulously phenotype (characterize) his or her patient and his or her family is what matters most. When the pursuit of the genotype gets in front of the establishment of the phenotype, bad things happen,” Dr. Ackerman says.

Co-authors are: Jaeger Ackerman, Jamie Kapplinger, David Tester, all of Mayo Clinic; Daniel Bartos, Ph.D., University of Kentucky and University of California, Davis; and Brian Delisle, Ph.D., University of Kentucky.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit mayoclinic.org/about-mayo-clinic or newsnetwork.mayoclinic.org.

About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 80 years and has a circulation of 130,000. Articles are available at mayoclinicproceedings.org.

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Thu, Jul 28 at 11:59am EST by @traciklein · View  

Mayo Clinic Studying Genomics of Antiplatelet Heart Medication

stethoscope and medication on cardiogramROCHESTER, Minn. — Which antiplatelet medication is best after a coronary stent? The Tailored Antiplatelet Therapy to Lessen Outcomes After Percutaneous Coronary Intervention (TAILOR-PCI) Study examines whether prescribing heart medication based on a patient’s CYP2C19 genotype will help prevent heart attack, stroke, unstable angina, and cardiovascular death in patients who undergo percutaneous coronary intervention (PCI), commonly called angioplasty.

TAILOR-PCI, which began in 2013 with study teams at 15 hospitals in the U.S., Canada and South Korea and plans to enroll 5,270 patients, just received an additional $7 million from the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), to complete the study. Twenty nine medical centers are now participating with more to be added soon. The randomized comparison of Plavix (clopidogrel bisulfate) and Brilinta (ticagrelor) was launched by Mayo Clinic Center for Individualized Medicine and the Department of Cardiovascular Diseases at Mayo Clinic in collaboration with Peter Munk Cardiac Centre, University Health Network, Toronto, and Spartan Bioscience, Ottawa.

“The NHLBI grant is validation of the importance of the question that needs to be answered: Is pharmacogenomics useful in prescribing individualized anti-platelet therapy after PCI,” says Naveen Pereira, M.D., Mayo Clinic cardiologist and principal investigator of TAILOR-PCI. “This study will tell us whether this gene plays an important role in determining response to anti-platelet therapy after coronary interventions.”

Michael Farkouh, M.D., M.Sc., cardiologist, Peter Munk Cardiac Centre, University Health Network, and principal investigator, describes this large, simple trial as “a true multinational collaboration designed to best inform clinical practice.”

Yves Rosenberg, M.D., the NHLBI program officer for the study, and chief of the Atherothrombosis and Coronary Artery Disease Branch, added, “NHLBI is happy to support this important study, which we hope will contribute to the evidence needed to start delivering precision medicine in clinical settings. This trial could have global impact by potentially changing treatment recommendations for millions of individuals with coronary artery disease needing antiplatelet treatment after a percutaneous coronary intervention.”

The costly and potential life-or-death question lingers after most of the 600,000 angioplasties performed every year in the U.S. The current standard of care after angioplasty is to prescribe clopidogrel for one year.

“Today, we do this regardless of a person’s individual genotype, even though we have known for several years that variation in the CYP2C19 gene may diminish the benefit from the drug,” Dr. Pereira says. “What we don’t know — and why there is such confusion in the cardiovascular community — is whether these genetic differences affect long-term clinical outcomes.”

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-284-5005, [email protected]

Antiplatelet medication reduces the risk of heart attack, unstable angina, stroke and cardiovascular death after stent placement by reducing the possibility of blood clots around the surgical site.

Clopidogrel, however, remains ineffective until the liver enzyme CYP2C19 metabolizes the drug into its active form. Some alternative medications, including ticagrelor, do not require activation through the same genetic pathway. Ticagrelor has its own risks, says Dr. Pereira, including serious or life-threatening bleeding. In addition, ticagrelor costs approximately six to eight times as much and must be taken twice a day, compared with clopidogrel.

“Answering this question is important for the most appropriate and best patient care, and it also will help physicians and patients use health care dollars most responsibly,” says Chet Rihal, M.D., chair of cardiovascular services for Mayo Clinic and study chair.

About Mayo Clinic's Center for Individualized Medicine
The Center for Individualized Medicine discovers and integrates the latest in genomic, molecular and clinical sciences into personalized care for each Mayo Clinic patient. For more information, visit http://mayoresearch.mayo.edu/center-for-individualized-medicine/.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or http://newsnetwork.mayoclinic.org/.

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Sun, Apr 3 at 11:30am EST by @traciklein · View  

Patients With Chest Pain Benefit From Decision Aid Tool Used With Physician

closeup of heart monitor with the text word alert
CHICAGO – Patients who arrive at the emergency department with low-risk chest pain and talk through treatment options with a physician show improved knowledge of their health status and follow-up options, compared with patients who received standard counseling from a physician, according to Mayo Clinic research presented at the American College of Cardiology’s 65th Annual Scientific Session.

Chest pain accounts for about 8 million emergency department visits each year in the U.S., but more than 90 percent of those patients are not experiencing a heart attack, says Erik Hess, M.D., lead author and emergency medicine physician at Mayo Clinic. “An electrocardiogram and blood tests can tell us if a patient is having a heart attack. Further testing may be needed to tell us if a patient faces an increased risk of heart attack in the near future. We wanted to know if there is value in discussing this further testing with patients.”

In the study, which involved 898 patients visiting six emergency departments in five states, half of the patients were randomly assigned to receive a physician discussion using Chest Pain Choice, the first patient-oriented tool designed to help shared decision-making between patients and physicians for chest pain. Patients were shown one-page information sheets that provide descriptions and graphics depicting a patient’s specific risk, such as a 2 percent risk of having a heart attack in the next 45 days and the next steps for care.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, [email protected]

Results showed that patients who received Chest Pain Choice increased their knowledge about their risk and options, answering 53 percent of questions on a questionnaire correctly, compared with 44.6 percent in the patients who received standard physician consultation. In addition, patients were asked to evaluate the experience of discussing their care with their physician. Of patients who received Chest Pain Choice, 68.9 percent said they would recommend the way they discussed care and options with their physicians, compared with 61.2 percent of those who received standard care.

“This trial shows that patient engagement in care can be beneficial to the patient’s understanding and treatment, and can lead to better care and more efficient use of resources,” Dr. Hess says, adding that Chest Pain Choice was associated with no major adverse heart events and led to a significantly lower proportion of patients receiving a stress test.

Co-authors are: Judd Hollander, M.D., Thomas Jefferson University; Jason Schaeffer, M.D., and Jeff Kline, M.D., both of Indiana University Bloomington; Deborah Diercks, M.D., University of Texas Southwestern; Russell Jones M.D., University of California, Davis; Jeph Herrin Ph.D., Yale University School of Medicine; Michel Demers; and Nilay Shah, Ph.D., Jonathan Inselman, Carlos Torres, M.D., Ph.D., Annie LeBlanc Ph.D., Ana Castaneda-Guarderas M.D., and Victor Montori, M.D., all of Mayo Clinic.

The study was funded by Patient-Centered Outcomes Research Institute and Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or http://newsnetwork.mayoclinic.org/.

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Fri, Apr 1 at 11:36am EST by @traciklein · View  

Smartphone App Used with Cardiac Rehab Helps Patients Lose More Weight

mobile cell phone screen with app icon imagesCardiac rehabilitation patients who also used a digital health tool to track and log exercise and dietary habits lost more weight than patients who used traditional cardiac rehab alone, according to Mayo Clinic study results that will be presented April 2 at the American College of Cardiology’s 65th Annual Scientific Sessions in Chicago.

For more on the study, see the ACC’s press release: http://www.acc.org/about-acc/press-releases/2016/03/24/12/48/digital-health-tool-helps-cardiac-rehab-patients-shed-more-pounds?w_nav=S

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or http://newsnetwork.mayoclinic.org/.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, [email protected]

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Nov 9, 2015 by @traciklein · View  

Genetic Risk Information for Coronary Heart Disease Leads to Lower Bad Cholesterol

ORLANDO, Fla. – A group of researchers led by Mayo Clinic has discovered that disclosing genetic risk for coronary heart disease (CHD) results in lower low-density lipoprotein cholesterol (LDL), also known as bad cholesterol. The findings of the Myocardial Infarction Genes (MI-GENES) Study were presented today at the annual American Heart Association Scientific Sessions 2015 as a late-breaking clinical trial.

LDL bad cholesterol word signIn this study, the investigators tested the hypothesis that incorporating genetic risk information into CHD risk estimates would lead to lowering of LDL levels. Participants were randomized to receive a CHD risk estimate that included genetic risk information versus an estimate based on conventional risk factors alone. Conventional risk factors include high blood pressure, diabetes, physical inactivity and a history of smoking. Six months after risk disclosure, the LDL levels were nearly 10 milligrams per deciliter of blood lower in those randomized to receive genetic risk information. The lower LDL levels resulted from a greater proportion of individuals in this group being started on statin medication.

“This study demonstrates for the first time that disclosing genetic risk information for a common disease such as CHD can result in changes in a relevant health outcome, in this case, LDL levels,” says Iftikhar Kullo, M.D., Mayo Clinic cardiologist and lead author. “The study also demonstrates the feasibility of placing genetic risk information into the electronic health record to empower patients and physicians to make decisions related to initiation of a statin medication. This is an important advance in the area of precision medicine for cardiovascular diseases.”

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, [email protected]

Journalists: Sound bites with Dr. Kullo are available in the downloads.

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Nov 9, 2015 by @traciklein · View  

Mayo Clinic study: One energy drink may increase heart disease risk in young adults

soda pop, energy drink cans

ORLANDO, Fla. — New research shows that drinking one 16-ounce energy drink can increase blood pressure and stress hormone responses significantly. This raises the concern that these response changes could increase the risk of cardiovascular events, according to a study presented today at the American Heart Association’s Scientific Sessions 2015. The findings also are published in the Journal of the American Medical Association.

“In previous research, we found that energy drink consumption increased blood pressure in healthy young adults,” says Anna Svatikova, M.D., Ph.D., a Mayo Clinic cardiology fellow and the first author. “We now show that the increases in blood pressure are accompanied by increases in norepinephrine, a stress hormone chemical, and this could predispose an increased risk of cardiac events – even in healthy people.”

Mayo Clinic researchers conducted a randomized, double-blind, placebo-controlled pilot study on 25 healthy volunteers with an average age of 29. Each participant consumed a 16-ounce energy drink and placebo drink within five minutes, in random order, on two separate days, with a maximum of two weeks apart. The placebo drink was similar in taste, texture and color, but lacked caffeine and other stimulants of the energy drink, such as taurine, guarana and ginseng.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, [email protected]

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Nov 8, 2015 by @traciklein · View  

Common medication for heart failure patients does not increase activity level

ORLANDO, Fla. — Heart failure patients with preserved ejection fraction (HFpEF) — where the heart becomes stiff and cannot relax or fill properly — did not have increased exercise tolerance after taking isosorbide mononitrate, compared to a placebo, according to a study presented today at the American Heart Association’s Scientific Sessions 2015. The findings come from the National Heart, Lung, and Blood Institute’s Heart Failure Clinical Research Network and are also published in the New England Journal of Medicine.
illustration of man having heart failure

Importantly, the HFpEF patients’ daily activity level was assessed with accelerometers, devices patients wore to measure movement throughout the study. Daily activity progressively and significantly decreased as the dose of the nitrate increased, says Margaret Redfield, M.D., first author and cardiologist at Mayo Clinic’s Rochester, Minnesota, campus.

“It is important to relieve symptoms in heart failure, so patients can be more active. Inactivity perpetuates deconditioning and frailty in heart failure,” Dr. Redfield says. “While nitrates are commonly prescribed for symptom relief in HFpEF, the effects of nitrates in patients with HFpEF have not been studied.”

In a multicenter, randomized, double-blind, two-period, 12-week crossover study called the Nitrate’s Effect on Activity Tolerance in Heart Failure with Preserved Ejection Fraction (NEAT-HFpEF) Trial, 110 patients with HFpEF at 20 sites were studied. Patients were randomized into one of two treatment groups:

  1. Six weeks of placebo first, followed by six weeks of isosorbide mononitrate
  2. Six weeks of isosorbide mononitrate, followed by six weeks of placebo

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, [email protected]

Journalists: Sound bites with Dr. Redfield are available in the downloads.

[...]

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Mar 23, 2015 by @traciklein · View  

Mayo Clinic Study First to Identify Spontaneous Coronary Artery Disease as Inherited


EMBARGO: Monday, March 23, at (11 am ET), JAMA Internal Medicine

A Mayo Clinic study has identified a familial association in spontaneous coronary artery dissection, a type of heart attack that most commonly affects younger women, suggesting a genetic predisposition to the condition, researchers say. The results are published in the March 23 issue of JAMA Internal Medicine.

Researchers used the Mayo Clinic SCAD Registry of 412 enrollees to identify five familial cases of SCAD, comprised of three pairs of first-degree relatives (mother-daughter, identical twin sisters, sisters) and two pairs of second-degree relatives (aunt and niece, and first cousins). Researchers believe this is the first study to identify SCAD as an inherited disorder.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-284-5005, email: [email protected]

Journalists: Sound bites with Dr. Hayes and SCAD animation are available in the downloads.

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Mar 13, 2015 by @traciklein · View  

Energy Drinks Raise Resting Blood Pressure, Dramatic In Those Not Used To Caffeine

Image of heart wrapped in blood pressure monitorSAN DIEGO — Healthy young adults who don’t consume caffeine regularly experienced greater rise in resting blood pressure after consumption of a commercially available energy drink — compared to a placebo drink — thus raising the concern that energy drinks may increase the risk of cardiac events, Mayo Clinic researchers found.

Results of the study will be presented Saturday, March 14, at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.

In this study, researchers alternately gave a can of a commercially available energy drink or a placebo drink to 25 healthy young adults, age 19 to 40, and assessed changes in heart rate and blood pressure. Blood pressure and heart rate were recorded before and 30 minutes after energy drink/placebo drink consumption, and were also compared between caffeine-naïve participants (those consuming less than 160 mg of caffeine per day,  the amount frequently found in a cup of coffee) and regular caffeine users (those consuming more than 160 mg of caffeine per day).

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Mar 13, 2015 by @traciklein · View  

Prolonged Shortened Sleep Increases Blood Pressure at Night

SAN DIEGO — People exposed to prolonged periods of shortened sleep have significant increases in blood pressure during nighttime hours, Mayo Clinic researchers report in a small study of eight participants.illustration describing how to measure blood pressure

Results of the study will be presented Sunday, March 15, at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.

In this study, eight healthy, normal weight participants, ages 19 to 36, participated in a 16-day inpatient protocol, consisting of a four-day acclimation period followed by nine days of either sleep restriction (four hours of sleep per night) or normal sleep (nine hours of sleep per night), and three days of recovery. Twenty-four blood pressure monitoring at regular intervals was measured at each study phase.

During the nighttime, in the sleep restriction phase compared to the normal sleep phase, systolic (top number) and diastolic (bottom number) blood pressure  averaged 115/64 millimeters of mercury (mm Hg) versus 105/57 mm Hg, respectively, researchers found. Furthermore, the expected fall in blood pressure during the night was suppressed when subjects had inadequate sleep. They also found that nighttime heart rate was higher with sleep restriction than in normal sleep.

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Mar 12, 2015 by @traciklein · View  

New Book “Caring for the Heart” Outlines History of Medical Specialization

Caring for the Heart bookROCHESTER, Minn. — Mayo Clinic announced today the release of a new book, “Caring for the Heart: Mayo Clinic and the Rise of Specialization.” This historical book weaves together three important themes: major developments in the diagnosis and treatment of heart disease in the 20th Century, how Mayo Clinic evolved from a family practice in Minnesota into one of the world's leading medical centers, and how the invention of new technologies and procedures promoted specialization among physicians and surgeons.

“Caring for the Heart” (Oxford, Hardcover Original, 704 Pages, $39.95, ISBN: 9780199982356) is written for general readers as well as health care professionals, historians and policy analysts. Unlike traditional institutional or disease-focused histories, this book places individuals and events in national and international contexts that emphasize the interplay of medical, scientific, technological, social, political, and economic forces that have resulted in contemporary heart care. Patient stories and media perspectives are included throughout to help general readers understand the medical and technological developments that are described.

The book is written so that readers may pick and choose the chapters of most interest to them. Another feature of the book is that readers may follow the stories without looking at the notes. Those who are interested in delving deeper into the main topics will find references that offer greater detail and additional perspectives. The descriptions and interpretations that fill the book benefit from the fact that the author has been a practicing cardiologist and medical historian for almost four decades.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-284-5005, email: [email protected] [...]

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Mar 10, 2015 by @traciklein · View  

JAMA: One-Year Data for Transcatheter Aortic Valve Replacement in U.S. Patients

ROCHESTER, MINN — Study results of one-year data for more than 12,000 patients who had transcatheter aortic valve replacement (TAVR) in the United States show an overall one-year death rate of 23.7 percent and a stroke rate of 4.1 percent, according to a study published in the March 10 issue of JAMA.

“Transcatheter aortic valve replacement has become transformational for patients who need a new valve and are at high-risk for surgery or inoperable. aortic valve stenosis TAVR illustrationBut we have been lacking long-term data for this group of patients who are considering this procedure,” says study lead author David R. Holmes, Jr., M.D., a Mayo Clinic interventional cardiologist. “Before this study, we only had 30-day information. This is a milestone and will help us better guide patients and learn as physicians.”

For the study, researchers used the Transcatheter Valve Therapies Registry, developed by the Society of Thoracic Surgeons and the American College of Cardiology, combining 12,182 TAVR patient procedures performed from November 2011 through June 2013 and linking to Centers for Medicare and Medicaid Services administrative claims for one-year data using direct Medicare patient identifiers (name and social security numbers).

Other important results from the study are: [...]

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Feb 11, 2015 by @traciklein · View  

Mayo Researcher Receives Woman's Day Red Dress Award

Virginia Miller, Ph.D.Dr. Virginia Miller, Director, Women’s Health Research Center, Mayo Clinic, director of the Women’s Health Research Center at Mayo Clinic, has spent her career researching how heart disease differs in women and men. On Feb. 10, she was honored for that work with a Woman’s Day Red Dress Award in New York City.

She received the award along with others who have made contributions in the fight against heart disease, the No. 1 killer of women today. Other award winners are: Andie MacDowell, actress and Go Red For Women spokesperson; CVS Health, the first national pharmacy chain to end tobacco sales; Margaret Hamburg, M.D., Former Commissioner of Food and Drugs, U.S. Food and Drug Administration; and Jennifer Donelan, WJLA TV ABC 7 reporter in Washington, D.C., and a heart attack survivor.

Dr. Miller’s research focuses on how sex hormones, such as estrogen and testosterone, affect the blood vessels and heart in women and men, as well as the role of other gender differences in cardiovascular health.

An important part of her research is to advocate for research that is sex-specific, meaning that research studies include both men and women, and that the results are analyzed separately by sex. Historically, and today even, that has not always happened, but it is so important, Dr. Miller says. “It is poor science to study one sex and apply the results to the other,” she says. “In the end, that does not help health care providers treat patients the best they can. With heart disease still as the No. 1 cause of death in women and men, we need to continue to research in the best ways possible in order to treat heart disease.”Red dress awards with Dr. Sharonne Hayes and Dr. Virginia Miller

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Nov 16, 2014 by @traciklein · View  

Patients with active asthma at higher risk for heart attack, Mayo Clinic research shows

CHICAGO — Patients with active asthma  — such as any use of asthma medications, and unscheduled office or emergency visits for asthma — are at a twofold risk of having a heart attack, according to Mayo Clinic research presented at the American Heart Association’s Scientific Sessions 2014.

Heart with stethoscopeResearchers compared 543 patients who had heart attacks with 543 non-heart attack patients of the same age and gender. These patients were treated at health care facilities in Rochester, Minnesota, between 2002 and 2006. The average age of patients was 67 years old, and 44 percent were women. Within the heart attack patient group, 81 patients had asthma, 44 of those with active asthma.

After controlling for traditional heart attack risk factors such as age, obesity, high blood pressure, smoking, diabetes and high cholesterol, a history of coronary heart disease, and conditions such as chronic obstructive pulmonary disease, results showed that patients with inactive asthma were not at an increased risk of heart attack, but those with active asthma were at a 70 percent risk, says Young Juhn, M.D., senior author and Mayo Clinic pediatric and adolescent physician and clinical epidemiologist. [...]

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Aug 15, 2014 by @traciklein · View  

Mayo Clinic Task Force Challenges Some Recommendations in Updated Cholesterol Treatment Guideline

A Mayo Clinic task force challenges some recommendations in the updated guideline for cholesterol treatment unveiled by the American College of Cardiology (ACC) and American Heart Association (AHA) in 2013. The task force concludes, based on current evidence, that not all patients encouraged to take cholesterol-lowering medications, such as statins, may benefit from them and that the guideline missed some important conditions that might benefit from medication.

Furthermore, the task force believes an emphasis needs to be placed on an individualized treatment approach with each patient and exercising shared decision-making.

heart stethoscopeRecommendations of the task force, made up of Mayo Clinic experts in cardiology, endocrinology and preventive medicine, with no conflicts of interest or links to the drug industry, will be published Aug. 14 in Mayo Clinic Proceedings. An editorial will accompany the paper. Mayo Clinic physicians are adopting the task force’s guideline.

“The ACC/AHA cholesterol guideline was last updated in 2001, so it needed to be updated. We agree with many points of the guideline, but there are some key areas where we do not completely agree or we wanted to expand and provide more guidance,” says Francisco Lopez-Jimenez, M.D., task force chairman and director of preventive cardiology at Mayo Clinic in Rochester, Minnesota.

Journalists: Sound bites with Dr. Kullo and Dr. Lopez-Jimenez are available in the downloads, as well as animations of statins' effects in the bloodstream and carotid artery plaque formation

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traciklein

Jun 24, 2014 by @traciklein · View  

BMI measurement may be missing 25 percent of children who could be considered obese, Mayo Clinic research says

heart stethoscopeROCHESTER, Minn. — Physicians using body mass index (BMI) to diagnose children as obese may be missing 25 percent of kids who have excess body fat despite a normal BMI, which can be a serious concern for long-term health, according to a Mayo Clinic study published online today in Pediatric Obesity.

The researchers found that BMI has high specificity in identifying pediatric obesity, meaning BMI accurately identifies children who are obese, but has a moderate sensitivity, meaning the BMI tool misses children who actually should be considered obese, according to the percent of fat in their bodies.

“If we are using BMI to find out which children are obese, it works if the BMI is high, but what about the children who have a normal BMI but do have excess fat? Those parents may get a false sense of reassurance that they do not need to focus on a better weight for their children,” says Francisco Lopez-Jimenez, M.D., senior study author and director of preventive cardiology at Mayo Clinic, Rochester, Minn.

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Mar 29, 2014 by @traciklein · View  

Mayo Research Shows Cardiac Rehab Patients Who Use Smartphone App Recover Better

American College of Cardiology

Washington — March 29, 2014 — Patients who attended cardiac rehabilitation and used a smartphone-based app to record daily measurements such as weight and blood pressure had greater improvements in those cardiovascular risk factors; they also were less likely to be readmitted to the hospital within 90 days of discharge, compared with patients who only attended cardiac rehabilitation, Mayo Clinic researchers found.

Journalists: Soundbites and b-roll with Dr. Widmer are available in the downloads.

Only 20 percent of the patients who attended cardiac rehab and used the app were readmitted to the hospital or visited the emergency department within 90 days, compared with 60 percent of those in the control group, researchers discovered.

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Feb 6, 2014 by @traciklein · View  

Surprising Trends in Cause of Long-Term Death for Heart Patients

ROCHESTER, Minn. — Feb. 6, 2014 — More people who have known coronary heart disease die from other causes — such as cancer, and lung and neurological diseases — than heart disease, compared with 20 years ago, according to a Mayo Clinic study published online Feb. 10 in Circulation, an American Heart Association journal.

Journalists: Sound bites with Dr. Gulati and b-roll of a cath lab are available in the downloads.

The researchers evaluated the trends in cause-specific, long-term mortality from 1991 to 2008 in patients at Mayo Clinic in Rochester who underwent percutaneous coronary intervention (PCI), a procedure used to open clogged heart arteries. They broke the study population into three eras: 1991 to 1996, 1997 to 2002, and 2003 to 2008. Cardiac deaths predominated in the first era and were about equal with non-cardiac deaths in the middle era. In the final era — the modern-era (2003 to 2008) — non-cardiac deaths dominated.
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Jan 21, 2014 by @traciklein · View  

Emergency Treatment Longer for Heart Attack Victims Arriving at Hospital During Off-Hours

ROCHESTER, Minn. — Jan. 21, 2014 — More people die and emergency hospital treatment takes longer for heart attack victims who arrive at the hospital during off-hours (nights and weekends), compared with patients who arrive during regular daily hours, according to a Mayo Clinic study published online in the British Medical Journal on Jan. 21.

Journalists: Sound bites with Dr. Sorita are available in the downloads.

Mayo Clinic researchers analyzed results of 48 studies published between 2001 and 2013 involving 1.8 million patients in the United States, Europe and Canada to assess the effect of off-hour hospital arrival for heart attack patients.

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