Heart Attack or Not? Test Might Tell

A Blood Test To Rule Out Heart...More Health HeadlinesAcuFacial: Look Years Younger Without...'Extreme Makeover': Sally Adams Loses 138...Swine Flu Cases SpikeDiscovery May Hold Key for Universal Flu...Bullied 14-Year-Old Girl Gets Plastic SurgeryIn The NewsArthritisAllergiesDr. Richard BesserCold & Flu Home> HealthHeart Attack or Not? New Test Might TellBy DR. SHARI BARNETT, ABC News Medical UnitAug. 13, 2012

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Joint Replacement Boosts Heart Attack Risk Right After Surgery: Study

HealthDay – 1 hr 40 mins ago MONDAY, July 23 (HealthDay News) -- People who have total hip or knee replacement surgery are about 30 times more likely to have a heart attack in the two weeks after the procedure, a new study finds.

Both surgeries are common treatments for arthritic hips and knees, with almost 2 million done around the world each year, the researchers noted.

"This study confirms the increased cardiac risk in the period following total hip and knee replacement," said lead researcher Dr. Arief Lalmohamed, from Utrecht University in the Netherlands. "Risk assessment and preoperative use of cardiovascular drugs may be necessary to reduce the risk of heart attack."

The effects of the operation are likely responsible for the increased risk of heart attack, Lalmohamed added. While the study showed an association between the two events, it did not prove a cause-and-effect relationship.

These side effects of surgery include the aftereffects of anesthesia on the cardiovascular system, blood loss, arrhythmias (irregular heartbeat) and lack of oxygen, all of which are known to increase risk of heart attacks, he said.

"In addition, the period before surgery itself is a very stressful time for the patient, even thinking about surgery increases cardiac risk," Lalmohamed said.

The report was published online July 23 in the Archives of Internal Medicine.

For the study, Lalmohamed's team used Danish registries to estimate the risk of heart attack after these operations.

In total, the researchers had data on more than 95,000 patients who underwent total hip or knee replacement surgery between January 1998 and December 2007.

The investigators compared the heart attack risk in these patients to more than 286,000 similar patients who didn't have surgery.

During the first two weeks after surgery, the risk for a heart attack was increased 25-fold for total hip replacement patients and 31-fold for total knee replacement patients, the study authors found.

The risk decreased rapidly after that, the researchers noted.

Six weeks after surgery, the absolute risk of a heart attack had dropped to 0.51 percent in patients who had a total hip replacement and 0.21 percent for those who had a total knee replacement, the investigators found.

The risk of having a heart attack was highest in those aged 60 and older, particularly patients aged 80 and older, and those who had experienced a heart attack in the six months before surgery. The latter increased the risk fourfold in the six weeks after the procedure, the authors noted.

"There is cardiac risk when a patient has a major operation," said Dr. Arthur Wallace, chief of the Anesthesia Service Veterans Affairs Medical Center in San Francisco.

"Anesthesiologists, surgeons and hospitalists need to use preoperative cardiac risk reduction to reduce that risk," added Wallace, who wrote an accompanying journal editorial.

Dr. Gregg Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles, said that "total hip replacement and total knee replacement are commonly performed surgeries, yet the risk of heart attacks occurring during or in the weeks following surgery have not been well-defined compared to the general population."

This new study shows the risk of a heart attack after these surgeries is small in absolute terms (one in 200 to one in 500 patients), he said.

"This increased heart attack risk may be lessened by careful preoperative cardiovascular risk assessment, continuation of aspirin, use of statin medications and careful monitoring in the first two to six weeks after orthopedic surgery," Fonarow said.

More information

For more information on joint replacement, visit the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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Forest Labs profit plunges; Icahn renews his attack

Reuters – 1 hr 33 mins ago (Reuters) - Forest Laboratories Inc, which is bracing for a proxy fight with activist investor Carl Icahn, said on Tuesday quarterly earnings tumbled 79 percent as generic competition ate into sales of its antidepressant Lexapro.

But the company also said efforts to diversify its product portfolio were paying off, with its three newest drugs selling well. New drug sales as well as signs that two new products could be approved by year-end pushed the company's shares up 1.7 percent on Tuesday, an analyst said.

Forest, which also makes the Alzheimer's drug Namenda, said net earnings in the fiscal first quarter ended June 30 fell to $55.3 million, or 21 cents a share, from $258.14 million or 90 cents a sharer a year earlier.

Analysts were expecting 24 cents a share, according to Thomson Reuters I/B/E/S.

The results did nothing to placate Icahn, who launched another broadside against the company in the form of a public letter to the board. In it he defended his nominees against claims by Forest that Icahn's nominees have conflicts of interest.

"Perhaps in your zeal to preserve the status quo at Forest you have failed to recognize that a lack of alignment with management is not a conflict of interest."

A spokeswoman for Forest said she was not immediately able to comment but would do so as soon as possible.

Net sales fell 31.9 percent to $751.8 million, hurt by competition from cheaper generics for Lexapro, which lost patent protection in March. Total revenue fell to $821.1 million from $1.15 billion.

The company last month cut its forecast for the year, saying it expects earnings of 65 to 80 cents a share, which would represent a decline of about 80 percent from 2012.

Icahn, Forest's second-largest shareholder, is seeking four seats on Forest's board. The annual meeting is set for August 15. Icahn failed to get his nominees elected to the board in 2011, but warned that his failure last year should not make the board complacent.

"Forest has underperformed your self-chosen peer companies by 21 percent since last year's meeting," he said. "Given that underperformance, it wouldn't surprise me if many shareholders vote differently this time around."

NAMENDA SALES RISE

Net sales of Namenda rose 15.2 percent to $368.4 million, missing the consensus estimate of $388 million.

While sales of blood pressure drug Bystolic rose 38.2 percent to $107.8 million, sales of the older drug Lexapro fell to $110 million from $585.7 million.

The company launched two new products last August: Daliresp, a drug to reduce the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD), and Viibryd for depression. Daliresp posted sales of $17.8 million in the first quarter, and Viibryd had sales of $37.4 million.

"The new products are the bright side, in particular the growth of Bystolic and Viibryd," said Aaron (Ronny) Gal, an analyst at Sanford C. Bernstein. "These are very nice numbers in largely generic markets."

He noted that management's long-term compensation is tied to the growth of the recently launched products.

Sales of Teflaro, a broad-spectrum antibiotic to treat community-acquired bacterial pneumonia, generated sales of $9.4 million. Teflaro was launched in March 2011.

Howard Solomon, Forest's chief executive, said in a statement that the company has "deliberately and strategically" diversified its product portfolio so that it will not be dependent on any single product or therapeutic area.

"We are pleased with the performance this quarter of three of our most recent product launches, Teflaro, Daliresp and Viibryd," he said. "It is still early days for these products but they are performing well in line with our expectations."

The company said it expects to hear from the U.S. Food and Drug Administration in the coming weeks on the approval status of its drug aclidinium for the long-term maintenance treatment of COPD, and later this summer it expects to hear whether the agency will approve its drug linaclotide for the treatment of irritable bowel syndrome with constipation and chronic constipation.

Assuming approval for both products, the company expects to launch them during fiscal 2013.

Forest shares were up 1.7 percent at $35.78 on Tuesday afternoon, just off the day's high at $35.82.

(Reporting by Toni Clarke in Boston; Editing by John Wallace, Sofina Mirza-Reid and Matthew Lewis)

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Risk factors for heart attack remain low seven years after gastric bypass

ScienceDaily (June 20, 2012) — Total cholesterol, triglycerides and C-reactive protein levels are among 11 risk factors for heart attack that remained greatly reduced up to seven years after gastric bypass surgery, according to a new Stanford University study

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Birth Control Linked to Heart Attack, Stroke

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Calcium supplements linked to significantly increased heart attack risk, study suggests

ScienceDaily (May 23, 2012) — Calcium supplements might increase the risk of having a heart attack, and should be "taken with caution," concludes research published in the online issue of the journal Heart.

See Also:Health & MedicineOsteoporosisWomen's HealthNutritionMind & BrainNutrition ResearchDieting and Weight ControlStrokeReferenceDietary mineralNutrition and pregnancyOily fishHormone replacement therapy

Furthermore, boosting overall calcium intake from dietary sources confers no significant advantage in terms of staving off heart disease and stroke, the findings indicate.

Previous research has linked higher calcium intake with a lowered risk of high blood pressure, obesity, and type 2 diabetes, all of which are risk factors for heart disease and stroke.

And calcium supplements are commonly recommended to elderly people and women who have gone through the menopause to prevent bone thinning.

The authors base their findings on almost 24,000 participants of one of the German arms of the European Prospective Investigation into Cancer and Nutrition (EPIC) study in Heidelberg.

All the participants were aged between 35 and 64 when they joined the study in 1994-8.

Normal diet for the preceding 12 months was assessed using food frequency questionnaires and they were quizzed about whether they regularly took vitamin or mineral supplements.

Their health was tracked for an average of 11 years, during which time 354 heart attacks, 260 strokes, and 267 associated deaths occurred.

After taking account of factors likely to influence the results, those whose diets included a moderate amount (820 mg daily) of calcium from all sources, including supplements, had a 31% lower risk of having a heart attack than those in the bottom 25% of calcium intake.

But those with an intake of more than 1100 mg daily did not have a significantly lower risk. There was no evidence that any level of calcium intake either protected against or increased the risk of stroke, which backs up the findings of other research, say the authors.

But when the analysis looked at vitamin/mineral supplements, it found that those who took calcium supplements regularly were 86% more likely to have a heart attack than those who didn't use any supplements.

And this risk increased further among those who used only calcium supplements. They were more than twice as likely to have a heart attack as those who didn't take any supplements.

The authors conclude: "This study suggests that increasing calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise

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Regional Systems to Treat Severe Heart Attack Increasing

HealthDay – 32 mins ago WEDNESDAY, May 23 (HealthDay News) -- The number of regional care systems able to quickly identify, transfer if necessary, and treat patients experiencing the most severe form of heart attack is increasing, new research finds.

ST-segment elevation myocardial infarction, or STEMI, is a deadly form of heart attack that affects nearly 300,000 people in the United States per year. It occurs when a blood clot completely blocks an artery to the heart. Quickly restoring blood flow is needed in order to prevent death.

In a regional STEMI-care system, emergency medical services have the equipment on their ambulances to diagnose the heart attack on the way to the hospital, and hospitals cooperate to make sure that patients are delivered to a facility that can quickly activate a team able to treat the heart attack. That treatment is often the artery-opening procedure called percutaneous coronary intervention, commonly known as angioplasty.

Between April 2008 and January 2010, the American Heart Association conducted a survey of 381 regional STEMI-care systems that included nearly 900 hospitals in 47 states. Each system included at least one hospital that performs angioplasty, and one emergency medical service provider.

The survey found that 67 percent of the systems were in urban areas and most followed standard procedures and policies, such as:

Admitting STEMI patients even when a hospital bed was not readily available (97 percent).Requiring a single phone call to activate the catheterization lab for angioplasty (92 percent).Permitting emergency department doctors to activate the catheterization lab without consulting a cardiologist (87 percent) and allowing the lab to be activated without a cardiology consultation before the patient arrives at the hospital (78 percent).Being part of a data collection registry (84 percent).

Competition among hospitals and cardiology groups was the most common barrier to implementing STEMI care systems. The researchers also found that about one-quarter of the systems have difficulties with emergency medical services' transport and finances.

The study appears in the journal Circulation: Cardiovascular Quality and Outcomes.

"It's essential to get competing hospitals and separate

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Optimism Might Cut Your Risk for Heart Attack

HealthDay – 30 mins ago WEDNESDAY, April 18 (HealthDay News) -- Being upbeat is good for your heart, a new study suggests.

Many previous studies have shown that negative mental states -- such as depression, anger, anxiety and hostility -- can harm the heart.

This Harvard School of Public Health review of more than 200 studies found that positive feelings appear to reduce the risk of cardiovascular disease and events such as heart attack and stroke.

"The absence of the negative is not the same thing as the presence of the positive," lead author Julia Boehm, a research fellow in the department of society, human development, and health, said in a university news release. "We found that factors such as optimism, life satisfaction and happiness are associated with reduced risk of

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Suicide, heart attack risk soars on cancer diagnosis: study

"Participants attend an Avon Walk For Breast Cancer in 2011 in New York City. People diagnosed with cancer have a sharply higher risk of suicide and fatal heart attacks immediately after receiving their diagnosis, a Swedish study published on Thursday shows. (AFP Photo/Dimitrios Kambouris)" title

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Cancer Diagnosis May Raise Odds for Suicide, Heart Attack Death

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Moderate Drinking Might Help Men Live Longer After Heart Attack

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Clot-buster Drug Injection Might Help Some Heart Attack Patients

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