News Release

News tips for Tuesday, November 9, 2004

From the American Heart Association's Scientific Sessions 2004

Peer-Reviewed Publication

American Heart Association

To complement our news releases, here are additional news tips reported by the American Heart Association's Public and Media Relations from more than 3,600 abstracts. Note: Stories are embargoed until papers are presented or poster sessions begin. Times are indicated with each entry; however, all embargoes will lift by 4 p.m. CST each day. For more information Nov. 7 –10, call Carole Bullock, Bridgette McNeill, or Julie Del Barto (broadcast) at the Ernest N. Morial Convention Center, New Orleans: (504) 670-6500. Before or after these dates, call Public and Media Relations in Dallas: (214) 706-1173 or 706-1396.

8:30 a.m. Abstract 2666 – Testosterone boosts blood flow to heart muscle in men with CAD. British doctors report positive results from experimental testosterone supplementation in men with coronary artery disease (CAD). Twenty-two men (average age 57) with known CAD were randomized to take 80 milligrams of testosterone daily or placebo. After eight weeks their treatment was reversed. After each eight weeks the men rested and underwent cardiovascular magnetic resonance (CMR) scans. Computer analyses of CMR images calculated blood supply to the two membranes around the heart muscle, the myocardium. Both of these "myocardial perfusion reserve indices" showed significant improvement on testosterone treatment. "In men with CAD and low plasma testosterone, chronic oral testosterone treatment improves myocardial perfusion reserve," the authors reported. Researchers said their findings support the potential clinical use of the male hormone to treat men with CAD.

8:30 a.m. Abstract 3721 – Cardiovascular risk factor trends: there's good news and not-so-good news. Researchers taking a fresh look at behavioral factors affecting cardiovascular disease risk find one trend that's good, and another that's decidedly not. A comparison of data from two large national health surveys (NHANES 1999-2000 and NHANES III) shows that smoking prevalence has decreased in black and white adults of all ages, and now is about equal in both groups. Overall, smoking by blacks declined from 34 percent to 26 percent, and by whites from 29 percent to 26 percent. Smoking prevalence was higher in black men than white men (33 percent versus 28 percent), but lower in black women than white women (21 percent versus 24 percent). The unwelcome news is that obesity in both races has increased significantly – from 29 percent to 40 percent overall for blacks, and from 21 percent to 29 percent for whites. Obesity increased 36 percent in black women, with nearly half of them – 49 percent – now considered obese, versus 30 percent of white women. Exercise rates were low: 19 percent for blacks versus 18 percent for whites. Researchers call the obesity increase "problematic."

8:45 a.m. Abstract 3690 – African-Americans have higher death risk after reperfusion. Studies have shown a higher death rate for African-Americans with coronary artery disease compared to Caucasians. Less is known about the relationship of African-American's outcome from a form of heart attack known as acute ST-elevation myocardial infarction (STEMI). Researchers evaluated data from 32,419 patients treated to restore blood flow to a block artery (reperfusion therapy) due to STEMI. Coronary angiography rates were similar but African-Americans were less likely to undergo a surgical procedure to restore blood flow. While death rates within 30 days for the two groups were similar, in-hospital stroke and bleeding, and one-year mortality were "significantly higher" among African-Americans. Detailed study of this disparity is needed, the scientists say.

9 a.m. Abstract 3763 – "Flight socks" reduce deep-vein leg clots during long air travel. Researchers may have found a method to reduce deep venous thrombosis (DVT), serious clotting in legs of at-risk individuals. In 1,000 patients identified to be at medium to high risk of DVT during long-haul flights (8-13 hours), researchers tested whether below-knee elastic stockings could reduce occurrence of DVT. Ultrasound scans detected DVT before and after flights in a group wearing "flight socks" and in a matched group of stocking-less controls. Below-knee DVTs were found in 1.1 percent of the stocking-wearers, while in the non-stocking group 4.6 percent had a DVT and 3.4 percent had a superficial blood clot. Researchers said the difference in the mostly asymptomatic clotting events were significant. Stockings were well tolerated with no side effects. Flight socks in association with an exercise program should be "very effective" in controlling DVT, according to researchers.

11:15 a.m. Abstract 2551 – Risk of post-op neurologic complications highest two days after bypass surgery. When are neurological complications most likely to strike after coronary artery bypass surgery? Ohio doctors studied 37,955 bypass patients' records over two decades. They found that 1,304 had a post-operative stroke, transient ischemic attack or coma. Of those, 254 (39 percent) of the complications presented upon awakening and 382 (59 percent) occurred later. The complications peaked around the second day after surgery. Factors predisposing patients for neurological events "reflect atherosclerotic disease and duration of cardiopulmonary bypass," the researchers reported. The good news: the risk of both early and delayed strokes has dropped significantly in recent years, along with increased awareness of aortic blockages, and steps to avoid clot formation.

2 p.m. Abstract 3029 – Depression may trigger silent ischemia in women with new angina. Women with recently diagnosed coronary heart disease are often depressed, but is the depression a consequence of, or a contributor to, disease severity? In a new study, 139 women who had new-onset angina underwent 24-hour electrocardiogram monitoring and heart rate (HR) variability analysis. Depressive symptoms were rated on a standard scale, with the women grouped as severely (group 1), mildly or non-depressed (2). Twenty-two women had normal coronary angiograms (NCA); the other 117 had significant heart disease (artery narrowing above 50 percent). The severely depressed group had 2.8 silent ischemic episodes versus 0.2 for the mildly depressed/non-depressed group, during a 24-hour ECG monitoring. This occurred both in women with NCA and with coronary heart disease. HR variability was lower in group 1. "Severe depression was associated with silent myocardial ischemia in women with de novo angina, having either normal coronary angiograms or coronary heart disease," reported the researchers, who say a potential pathway may be the effects of the sympathetic nervous system on coronary circulation.

2 p.m. Abstract 3035 – Can parents' perspective offer clues to quality of life in children with heart disease? Prolonged life expectancy in children with heart disease prompts increased focus on their health-related quality of life (QOL). How do parents perceive physical and psychosocial aspects of emotional, social and school functioning by these children? Researchers used the Pediatric Quality of Life Inventory to study 408 parents (83 percent mothers) of children aged 2- to 18-years-old with heart disease. Illness severity was rated from 1 (mild – no surgery) to 4 (complex/severe – uncorrectable or palliative repair). Researchers found that a majority of the children with heart disease have good quality of life, but about one child in five is at risk for "impaired psychosocial QOL" as perceived by their parents. Impaired psychosocial functioning may be related to the parent's perception of the child's physical functioning, especially in those over age 5, but was not related to clinician rating of disease severity, the researchers said. In light of the potential discord between disease severity and parental perceptions, clinicians should be alert to parents' perspective to identify potential "psychosocial morbidity" in children with heart disease.

3 p.m. Abstract 1153 – Experimental vaccination reduces artery plaque growth in mice. In a study in the Netherlands, a vaccination that included interleukin (IL-12) brought "significant reduction" in artery plaque buildup in mice. IL-12 is a white-cell protein thought to play a key role in development of atherosclerosis. When vaccinated, LDL receptor-deficient mice formed antibodies to interleukin 12. The injections blocked biological action by IL-12, and reduced its signaling response by 90 percent. Two weeks after final vaccinations, injected animals had a 68 percent reduction in the rate of plaque formation on carotid artery walls, compared to control mice. There was also less vessel wall thickening and a 57 percent decrease in artery narrowing (stenosis). Thus IL-12 vaccine blockade may become "a promising strategy for the treatment of atherosclerosis," the scientists said.

4:30 p.m. Abstract 3775 – Women's coffee drinking may reduce insulin secretion marker in blood. Regular coffee consumption is associated with reduced risk of diabetes and possibly hypertension and cardiovascular disease, but the mechanism is not clear. Researchers found an inverse association between women's coffee drinking and levels of C-peptide in the blood. C-peptide is a component of insulin, which helps glucose (blood sugar) enter cells and provides the energy cells need to function properly. High levels indicate insulin resistance (the body's inability to use insulin efficiently) a major factor in the development of type 2 diabetes. Researchers examined the records of 2,112 women participating in the Nurses' Health Study. They compared the women's self-reported consumption of caffeinated coffee, decaffeinated coffee, and total caffeine in 1984, 1986, and 1990 to the levels of C-peptide in frozen blood samples drawn from the women in 1990. In all three categories, the larger the amount ingested, the lower the level of C-peptide. Women who drank more than four cups of caffeinated or decaffeinated coffee a day had C-peptide levels 13 percent and 14 percent lower, respectively, than women who never drank coffee. The association was much stronger in obese women (22 percent reduction) and overweight women (18 percent reduction) than in normal-weight women (9 percent reduction). Researchers say the findings suggest a potential reduction of insulin secretion by both caffeinated and decaffeinated coffee in women, and the potential implications appear particularly important for obese and overweight women.

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Statements and conclusions of study authors that are published in the American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.


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