Everolimus-eluting stent safer, more effective than paclitaxel-eluting stent

London, May 6 (ANI): Everolimus-eluting stents demonstrate enhanced safety and efficacy in the treatment of de novo native coronary artery lesions when compared to paclitaxel-eluting stents, scientists have discovered.

Results from the SPIRIT IV clinical trial, which were first presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2009 scientific symposium, were published in the New England Journal of Medicine.

The trial, a large-scale multi-center study of nearly 4,000 patients in the U.S., also examined the differences in performance of the two stents in patients with diabetes.

“The data published in today”s New England Journal of Medicine, and first reported at TCT, demonstrate enhanced safety and efficacy of the everolimus-eluting stent compared to the paclitaxel-eluting stent in this large-scale study without routine angiographic follow-up. The study results also suggest that minimal late loss may be achieved with drug-eluting stents without sacrificing safety,” said principal investigator Gregg W. Stone, MD, Professor of Medicine at Columbia University College of Physicians and Surgeons, Director of Cardiovascular Research and Education at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center and Co-Director of the Medical Research and Education Division at the Cardiovascular Research Foundation. (ANI)

Cardiovascular disease mortality in China to rise by 73 percent by 2030

New York, May 5 (ANI): Researchers have projected that aging, smoking, high blood pressure and other risk factors will increase annual heart disease and stroke rates in China by up to a drastic 73 percent by 2030.

This would mean that 21.3 million more people will die of cardiovascular diseases alongwith 7.7 million related deaths.

The only way to avoid such a situation would be if China dramatically eliminates smoking in men, or lowers high blood pressure in men and women.

“China is a prime example of a middle income nation in transition. The country’s standard of living and life expectancy have improved for many, but aging, dietary changes and less physical activity are leading to more heart disease and stroke,” said lead author Andrew Moran, M.D., M.P.H., assistant professor at Columbia University Medical Center in New York City, N.Y.

“Our study used a computer model to forecast future cardiovascular disease in Chinese adults, and is the first to project the individual and combined effects of major risk factor trends on a national scale.”

Demographic changes will be the main driver of the CVD epidemic in China in the next two decades, Moran said.

To counter this possibility, Moran advises an aggressive anti-tobacco policy and control of elevated blood pressure.

Moran and colleagues reviewed risk factor surveys of Chinese adults, ages 35-84, since economic reforms in the 1980s, and used them to project future trends in blood pressure, cholesterol, smoking, diabetes and body weight.

Although smoking prevalence has declined in men by more than 10 percent since the mid 1980s, 62 percent of Chinese men still smoke, and 49 percent of non-smokers, mostly women, are exposed to passive smoke, researchers said. (ANI)

Acupuncture could relieve joint pain linked to breast cancer treatments

Washington, Mar 5 (ANI): Acupuncture could be an effective therapy for joint pain and stiffness in breast cancer patients who are being treated with commonly used hormonal therapies, says a new study.

Joint pain and stiffness are common side effects of aromatase inhibitor therapy, in which the synthesis of estrogen is blocked.

Researchers at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia University Medical Center, led the new study.

It was previously shown that the therapy, which is a common and effective treatment for early-stage, hormone-receptor-positive breast cancer in post-menopausal women, causes some joint pain and stiffness in half of women being treated.

“Since aromatase inhibitors have become an increasingly popular treatment option for some breast cancer patients, we aimed to find a non-drug option to manage the joint issues they often create, thereby improving quality of life and reducing the likelihood that patients would discontinue this potentially life-saving treatment,” said Dr. Dawn Hershman, senior author of the paper.

To explore the effects of acupuncture on aromatase inhibitor-associated joint pain, researchers randomly assigned 43 women to receive either true acupuncture or sham acupuncture twice a week for six weeks.

Sham acupuncture, which was used to control for a potential placebo effect, involved superficial needle insertion at body points not recognized as true acupuncture points.

All participants were receiving an aromatase inhibitor for early breast cancer, and all had reported musculoskeletal pain.

In women treated with true acupuncture, it was shown that they experienced significant improvement in joint pain and stiffness over the course of the study.

Pain severity declined, and overall physical well being improved.

In addition, 20 percent of the patients who had reported taking pain relief medications reported that they no longer needed to take these medications following acupuncture treatment.

However, no such improvements were reported in women who were treated with the sham acupuncture.

“This study suggests that acupuncture may help women manage the joint pain and stiffness that can accompany aromatase inhibitor treatment,” said Dr. Katherine D. Crew, first author of the paper.

“To our knowledge, this is the first randomized, placebo-controlled trial establishing that acupuncture may be an effective method to relieve joint problems caused by these medications. However, results still need to be confirmed in larger, multicenter studies,” she added.

The results of the study were published in the Journal of Clinical Oncology. (ANI)

Oxygen-saturated blood can reduce heart muscle damage after an attack

Washington, September 16 (ANI): An infusion of blood that is “supersaturated” with oxygen (SS02) can reduce the amount of damaged heart muscle immediately following a life-threatening heart attack, say researchers.

This is a finding made during a clinical trial, published in Circulation: Cardiovascular Interventions.

“The benefit of this therapy increased with the scope of the heart attack,” said Dr. Gregg W. Stone, lead author and professor of medicine at Columbia University College of Physicians and Surgeons and director of cardiovascular research and education in the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center.

“The data show that heart muscle can be saved even after severe heart attack,” added Dr. Stone, who is also the immediate past chairman of the Cardiovascular Research Foundation in New York.

The AMIHOT-II study focused on patients having the most serious types of heart attacks – those with anterior ST-segment elevation myocardial infarctions (STEMIs) – and on those treated within 6 hours.

Nearly half of the 733,000 Americans who suffer acute coronary syndromes-heart attack or chest pain-each year have a STEMI, according to the American Heart Association.

When a large area of the heart is damaged, heart failure is more likely, and catheter-based percutaneous coronary intervention is a procedure that can effectively open blocked arteries in STEMI patients, Dr. Stone said.

In the trial, the “supersaturated” oxygen was delivered through catheter directly to the area of the heart muscle affected by the heart attack.

The size of the “infarct zone”-the amount of damaged tissue-was significantly reduced in the patients that received the “supersaturated” oxygen.

Upon analysis of their data from the study, the researchers observed that the median size of the “infarct zone” was 20 percent in the patients that received the “supersaturated” blood, and 26.5 percent in the control group.

Besides that, at 30 days after the treatment a key safety measure-the rates of major adverse cardiac events-were not statistically different between the two groups. (ANI)

Gastrin levels vital in bacterial-induced stomach cancer

Washington, June 24 (ANI): Gastrin levels have a very important role to play in the development of Helicobacter-induced stomach cancer, according to a study.

Over 50 percent of the world’s population is infected with Helicobacter pylori, which causes chronic inflammation of the stomach lining, and is strongly linked to the development of gastric ulcers and stomach cancer.

Stomach cancer is the second leading cause of cancer-related deaths worldwide.

Helicobacter infection results in increased expression of gastrin, a hormone that stimulates secretion of gastric acid.

However, the role of gastrin in cancer development still remains unclear.

While high levels of gastrin lead to the development of stomach cancer, but absence of gastrin has been shown to increase the numbers of tumours in the gastric antrum- the lower section of the stomach that empties into the small intestine.

Thus, for explaining this apparent disparity, a group led by Dr. Timothy Wang at the Columbia University Medical Center in New York, NY examined the contribution of Helicobacter infection to gastric cancer in animal models with either high expression of gastrin or no gastrin at all.

It was found that Helicobacter infection in mice with high levels of gastrin resulted in cancer of the gastric corpus (main body of the stomach).

On the other hand, infection in gastrin-deficient mice led to cancer in a different part of the stomach- the gastric antrum.

Thus, the researchers concluded that gastrin plays a key role in the development of Helicobacter-induced stomach cancer, but may have distinct effects on carcinogenesis in different parts of the stomach.

The related report by Takaishi et al, ‘Gastrin is an essential cofactor for Helicobacter-associated gastric corpus carcinogenesis in C57BL/6 mice’, is appearing in the upcoming issue of The American Journal of Pathology. (ANI)

Drug-eluting stents found to be superior in efficacy to bare metal stents

London, May 7 (ANI): A study suggests that the use of drug-eluting stents on heart attack patients undergoing angioplasty is more effective and as safe as that of bare-metal stents.

Lead researcher Dr. Gregg W. Stone, a professor of medicine at Columbia University Medical Center/New York-Presbyterian Hospital, has revealed that in patients undergoing angioplasty, the use of paclitaxel-eluting stents has been found to reduce rates of target lesion revascularization (TLR) and binary angiographic restenosis when compared to the use of bare-metal stents after 1 year.

The study also revealed that the primary safety measure of major adverse cardiovascular events (MACE)-including death, reinfarction, stent thrombosis and stroke-established the non-inferiority of drug-eluting stents with respect to safety through 1 year.

The trial enrolled 3,602 heart attack patients at 123 centers in 11 countries, 3,006 of whom were randomised to paclitaxel-eluting stents versus otherwise identical bare metal stents.

During the trial, the use of paclitaxel-eluting stents resulted in a significant reduction of ischemia-driven target-lesion revascularization (TLR)-the rate at which a particular lesion re-narrows following stent implantation severely enough to require either a repeat angioplasty or bypass surgery operation-at 12 months.

The use of paclitaxel-eluting stents also resulted in a significant reduction in binary restenosis after 13 months, which is the rate at which the artery re-narrows at least 50 per cent following implantation of the stent, and was the secondary efficacy endpoint of the trial. The paclitaxel-eluting stent had a rate of 10 per cent and the bare metal stent had a rate of 22.9 per cent.

“Outcomes from prior registry and randomised trials of drug-eluting stents compared to bare metal stents in heart attack patients have been conflicting. These results now provide definitive evidence that paclitaxel-eluting stents are superior in efficacy to bare metal stents and have a comparable safety profile at 1 year,” said Dr. Stone.

The researchers believe that the findings of their study will have a major impact on how decisions are made regarding drug-eluting and bare metal stents in the highest risk patients, those in the early hours of a heart attack.

“This study removes much of the uncertainty and concern about the efficacy and safety of drug-eluting stents in this clinical setting. Moreover, all of the patients in this trial will be followed long-term to ensure that these favorable results are maintained,” said Dr. Stone.

A research article on the trial has been published in The New England Journal of Medicine. (ANI)

Herbal therapeutic Zyflamend shows promise in treatment of men at prostate cancer risk

Washington, May 23 (ANI): A novel herb-based therapeutic called Zyflamend has been found to be linked with minimal toxicity and no serious adverse events in men at high-risk for developing prostate cancer in its phase I clinical trial.

The trial was led by researcher from the Center for Holistic Urology at Columbia University Medical Center and NewYork-Presbyterian Hospital/Columbia.

Writing in the Journal of the Society for Integrative Oncology, the researchers revealed that 23 men aged 40-75 years, who were diagnosed with an increased risk of developing prostate cancer, were admitted into this prospective clinical trial to determine the safety and tolerability of Zyflamend when administered orally for 18-months, either alone or along with various dietary supplements.

“Since we know that men with HGPIN have an increased risk for developing prostate cancer, new strategies formulated to decrease cancer risk, prevent or delay surgery, and improve quality of life, will be greatly beneficial for these men,” said senior author of the study Dr. Aaron E. Katz, an associate professor of Urology at Columbia University College of Physicians and Surgeons.

The researchers say that basic science studies have suggested that Zyflamend may have an anti-inflammatory mechanism of action, and the agent has been found to be effective in decreasing the proliferation of prostate cancer in cell culture.

“Our results confirm that Zyflamend, in a dose of three times daily for up to 18-months, was well tolerated,” said Dr. Jillian L. Capodice, director of the Acupuncture Research and Integrative Clinical Service of the Department of Urology’s Center for Holistic Urology, at Columbia University College of Physicians and Surgeons. (ANI)

How to reduce stroke risk

Washington, May 14 (ANI): It takes less than a minute for a stroke to change a person’s life forever. However, a few lifestyle changes and knowing the most common signs can save an individual from the potentially fatal attack.

The most simple and effective way to reduce stroke risk is exercise. If you are obese or overweight, your risk factors for high cholesterol, high blood pressure and diabetes increases and so does your risk for a stroke.

Extra weight places an added strain on your entire circulatory system, but aerobic exercise can be a good way to lose those extra pounds and substantially improve your health.

High blood pressure is also one of the leading causes of stroke, however reducing salt intake can significantly help reduce the risk.

A heart-healthy diet and maintaining the balance between good cholesterol (HDL) and bad cholesterol (LDL) is the best way to prevent heart disease and the increased risk of stroke.

People are advised to quit smoking as a smoker is at twice the risk of having a stroke. Smoking damages blood vessels, raises blood pressure and speeds up the clogging of arteries.

“When someone does have a stroke they may experience either slight or extremely noticeable physical changes,” said Dr. Randolph Marshall, director of the Stroke Division at NewYork-Presbyterian Hospital/Columbia University Medical Centre.

“The most effective way to prevent the permanent damage associated with stroke is to recognize the signs of an attack and to seek medical attention immediately,” he added.

The most common signs of a stroke are

1. Sudden numbness or weakness in the face, arms or legs — specifically on one side of the body.

2. Trouble speaking, with a feeling of confusion and slurred speech or trouble speaking.

3. Loss of Balance. Dizziness and trouble walking.

4. Poor Eyesight. A loss of vision in one or both of the eyes

5. Headache. A sudden headache that occurs for no apparent reason. (ANI)

Drug-eluting stents found to be superior in efficacy to bare metal stents

Washington, May 7 (ANI): A study suggests that the use of drug-eluting stents on heart attack patients undergoing angioplasty is more effective and as safe as that of bare-metal stents.

Lead researcher Dr. Gregg W. Stone, a professor of medicine at Columbia University Medical Center/New York-Presbyterian Hospital, has revealed that in patients undergoing angioplasty, the use of paclitaxel-eluting stents has been found to reduce rates of target lesion revascularization (TLR) and binary angiographic restenosis when compared to the use of bare-metal stents after 1 year.

The study also revealed that the primary safety measure of major adverse cardiovascular events (MACE)-including death, reinfarction, stent thrombosis and stroke-established the non-inferiority of drug-eluting stents with respect to safety through 1 year.

The trial enrolled 3,602 heart attack patients at 123 centers in 11 countries, 3,006 of whom were randomised to paclitaxel-eluting stents versus otherwise identical bare metal stents.

During the trial, the use of paclitaxel-eluting stents resulted in a significant reduction of ischemia-driven target-lesion revascularization (TLR)-the rate at which a particular lesion re-narrows following stent implantation severely enough to require either a repeat angioplasty or bypass surgery operation-at 12 months.

The use of paclitaxel-eluting stents also resulted in a significant reduction in binary restenosis after 13 months, which is the rate at which the artery re-narrows at least 50 per cent following implantation of the stent, and was the secondary efficacy endpoint of the trial. The paclitaxel-eluting stent had a rate of 10 per cent and the bare metal stent had a rate of 22.9 per cent.

“Outcomes from prior registry and randomised trials of drug-eluting stents compared to bare metal stents in heart attack patients have been conflicting. These results now provide definitive evidence that paclitaxel-eluting stents are superior in efficacy to bare metal stents and have a comparable safety profile at 1 year,” said Dr. Stone.

The researchers believe that the findings of their study will have a major impact on how decisions are made regarding drug-eluting and bare metal stents in the highest risk patients, those in the early hours of a heart attack.

“This study removes much of the uncertainty and concern about the efficacy and safety of drug-eluting stents in this clinical setting. Moreover, all of the patients in this trial will be followed long-term to ensure that these favorable results are maintained,” said Dr. Stone.

A research article on the trial has been published in The New England Journal of Medicine. (ANI)

Why certain arterial plaques result in deadly heart attack, stroke

Washington, May 6 (ANI): Scientists at Columbia University Medical Center say that they have gained significant insights into why certain arterial plaques in any given individual eventually lead to an acute blood clot, a heart attack, a stroke, or even sudden death.

The researchers also claim to have identified a key protein that may promote the conversion from benign to dangerous plaques.

While a vast majority of atherosclerotic lesions are relatively harmless, some two percent of all plaques turn out to be problematic.

What separates the average blood vessel plaque from those that are at high risk for triggering the development of dangerous – even fatal – blood clots, is the “billion dollar question,” says lead researcher Dr. Ira Tabas.

Dr. Tabas believes that the real danger from the fatty deposits lies not with their size, but with what lies underneath the surface of the deposit. The researcher says that rumblings in the core of a deposit, which contains dead cells, can break open the plaques.

Once the plaque ruptures, a blood clot in the lumen of the artery can form.

“It is this sudden clotting that restricts blood flow and can cause a heart attack, stroke, or sudden cardiac death,” Dr. Tabas says.

“Just about everybody in our society has atherosclerosis by the time we reach 20. So the wave of the future in treating atherosclerosis will be in preventing harmless lesions in young people from becoming dangerous ones, or soothing dangerous plaques so they don’t rupture as we age,” Dr. Tabas adds.

During the study, the research team found that when a specific gene was deleted in two separate strains of atherosclerosis-prone mice, the dangerous plaques were much smaller.

Dr. Tabas has revealed that the gene encodes a protein that is part of a cell stress reaction that can lead to cell death.

The researcher says that the findings of this study raise the possibility that drugs designed to quiet this form of cellular stress might be useful in treating heart disease.

Dr. Tabas, however, concedes that it may take years before such a therapy is available.

The study has been published in the journal Cell Metabolism. (ANI)

Scientists identify brain protein key to Parkinson’s disease, drug addiction

Washington, May 5 (ANI): Scientists at Columbia University Medical Center and the University of Rochester Medical Center have identified a protein that seems to be key to the processes that lead to Parkinson’s disease, and is involved in the brain’s response to addictive drugs like methamphetamine.

Telling that this protein is called organic cation transporter 3 (oct3), the researchers have revealed that their work fills a longstanding gap in scientists’ understanding of the brain damage that causes symptoms like tremor, stiffness, slowness of movement and postural instability.

The researchers have found that oct3, which shepherds molecules into and out of cells, plays a critical role by bringing toxic chemicals to the doorstep of the brain cells that die in patients with Parkinson’s disease.

They have also shown that oct3 is involved in the brain’s response to methamphetamine and other addictive drugs.

According to them, their study supports a role for astrocytes, a type of brain cells that has been often overlooked by scientists focused more on cells known as neurons that send electrical signals.

“Astrocytes are definitely much more than support cells in the brain. Scientists are discovering their involvement in many diseases. The latest results point to their role in Parkinson’s disease,” said Dr. Kim Tieu, assistant professor in the Department of Environmental Medicine at the University of Rochester Medical Center.

Tieu, who initiated the study as a post-doctoral research associate in the laboratory of Dr. Serge Przedborski, the Page and William Black Professor of Neurology at Columbia University, has revealed that they chose to study how the brain handles a chemical known as MPTP, which ultimately damages the exact same brain cells that are injured in patients with Parkinson’s disease.

While MPTP does not cause Parkinson’s disease, scientists regularly use it as a model for the disease because it causes an identical type of brain damage.

In the brain, this chemical is known to convert primarily in astrocytes to a chemical called MPP+, which is deadly to dopamine neurons.

An over two-decade-old study suggests that MPP+ is released from astrocytes before it kills dopaminergic neurons, but exactly how it is freed from astrocytes has been a mystery.

The current study has now shown that oct3 as the shepherd that escorts toxic MPP+ out of the astrocytes and into the space surrounding dopamine neurons, which is where another molecule known as the dopamine transporter picks it up and brings it into the neuron itself.

Upon blocking or genetically removing oct3 in mice, the researchers found that the dopamine neurons in the brains did not die despite the presence of MPTP in the brain. When oct3 was present in the usual amounts, dopamine neurons died as expected.

“The neurons affected in Parkinson’s disease don’t live in isolation in the brain. You must understand the brain environment as a whole to understand disease. For many years, people had a neuron-centric view of neurodegenerative diseases. But more and more scientists are realizing that if you wish to understand the process of neurodegeneration, you must take into account the astrocytes, the microglia, as well as the neurons. Astrocytes maintain an intimate relationship with neurons, and to understand one, you have to understand the other,” said Przedborski.

Analysing brain tissue from people who died of Parkinson’s disease, the researchers found oct3 to be active in astrocytes in the brain region affected by Parkinson’s disease.

The team found the same while experimenting on mice, where the absence of oct3 correlated exactly to areas of the brain where neurons were not damaged.

The finding that oct3 may play a role matches other scientists’ observations that people in whom its activity is reduced have a higher potential for addiction.

The researchers believe that the molecule may also offer a new target for treating depression. Since one of oct3′s functions is to remove serotonin from the brain, blocking it may offer a new avenue to treat depression.

A research paper based on their study has been published in the online edition of the Proceedings of the National Academy of Sciences. (ANI)

Scientists identify ‘molecule trio’ that kills neurons in Parkinson’s

Washington, Apr 30 (ANI): In a novel study, researchers at Columbia University Medical Centre have identified a trio of molecules that are responsible for killing brain cells in Parkinson’s patients.

They have showed that three molecules – the neurotransmitter dopamine, a calcium channel, and a protein called alpha-synuclein – act together to kill the neurons.

The symptoms of Parkinson’s – including uncontrollable tremors and difficulty in moving arms and legs – are blamed on the loss of neurons from the substantia nigra region of the brain.

“Though the interactions among the three molecules are complex, the flip side is that we now see that there are many options available to rescue the cells,” said Dr Eugene Mosharov, associate research scientist and study’s author.

The researchers showed that neurons die because calcium channels lead to an increase of dopamine inside the cell; excess dopamine then reacts with alpha-synuclein to form inactive complexes; and then the complexes gum up the cell’s ability to dispose of toxic waste that builds up in the cell over time. The waste eventually kills the cell.

The neurons will survive if just one of the three factors is missing, said the researchers.

“It may be possible to save neurons and stop Parkinson’s disease by interfering with just one of the three factors,” Dr. Mosharov added.

The researchers hope that a drug already in clinical trials – which blocks the culprit calcium channel – may work to slow or stop the progression of the disease.

The study is published in journal Neuron. (ANI)

Structural changes in brain’s cortex linked to higher depression risk

Washington, Mar 24 (ANI): A structural difference in the brain – a thinning of the right hemisphere – is linked to a higher risk for depression, according to American researchers.

Myrna Weissman, Ph.D., professor of epidemiology in psychiatry, led the research at Columbia University Medical Center and the New York State Psychiatric Institute.

It was found that people at high risk of developing depression had a 28 percent thinning of the right cortex, the brain’s outermost surface, as compared to people with no known risk.

The researchers said that the drastic reduction is similar to the loss of brain matter typically observed in persons with Alzheimer’s disease and schizophrenia.

“The difference was so great that at first we almost didn’t believe it. But we checked and re-checked all of our data, and we looked for all possible alternative explanations, and still the difference was there,” said Peterson.

Peterson said that the thinner cortex might increase the risk of developing depression by disrupting a person’s ability to pay attention to, and interpret, social and emotional cues from other people.

Additional tests measured each person’s level of inattention to and memory for such cues and it was found that the less brain material a person had in the right cortex, the worse they performed on the attention and memory tests.

In the study, the researchers compared the thickness of the cortex by imaging the brains of 131 subjects, aged 6 to 54 years old, with and without a family history of depression.

Structural differences were observed in the biological offspring of depressed subjects but were not found in the biological offspring of those who were not depressed.

One of the goals of the study was to determine whether structural abnormalities in the brain predispose people to depression or are a cause of the illness.

The study found that thinning on the right side of brain had no link with actual depression, only an increased risk for the illness.

But the subjects, who exhibited an additional reduction in brain matter on the left side, went on to develop depression or anxiety.

“Our findings suggest rather strongly that if you have thinning in the right hemisphere of the brain, you may be predisposed to depression and may also have some cognitive and inattention issues. The more thinning you have, the greater the cognitive problems. If you have additional thinning in the same region of the left hemisphere, that seems to tip you over from having a vulnerability to developing symptoms of an overt illness,” said Peterson.

The study is published in the upcoming early online edition of the Proceedings of the National Academy of Sciences (PNAS). (ANI)

Being depressed could break your heart, literally

Washington, Mar 10 (ANI): Relatively healthy women with severe depression are at increased risk of cardiac events, including sudden cardiac death (SCD) and fatal coronary heart disease (CHD), says a new study.

In the study, boffins found that much of the relationship between depressive symptoms and cardiac events was mediated by cardiovascular disease risk factors, such as high blood pressure, high cholesterol and smoking.

“It’s important for women with depression to be aware of the possible association between depression and heart disease, and work with their health care providers to manage their risk for coronary heart disease,” says William Whang, M.D., M.S., Division of Cardiology, Columbia University Medical Center, and lead investigator of the study.

“A significant part of the heightened risk for cardiac events seems to be explained by the fact that coronary heart disease risk factors such as high blood pressure, diabetes, elevated cholesterol, and smoking were more common among women with more severe depressive symptoms,” the expert added.

To reach eth conclusion, Dr. Whang and his colleagues prospectively studied 63,469 women from the Nurses Health Study who had no evidence of prior heart disease or stroke during follow-up between 1992 and 2004.

Self-reported symptoms of depression and use of antidepressant medication were used as measures of depression. To best identify those with clinical depression, researchers specifically examined women with the most severe symptoms defined by a validated 5-point mental health index score of less than 53 or regular antidepressant use.

The study found that women with more severe depressive symptoms or those who reported taking antidepressants were at higher risk for SCD and fatal CHD. In particular, women with clinical depression were more than twice as likely to experience sudden cardiac death.

Surprisingly, this risk was associated more strongly with antidepressant use than with depressive symptoms.

“These data indicate the link between depression and serious heart rhythm problems may be more complex than previously thought,” says Sanjiv M. Narayan, M.D., F.A.C.C., University of California, San Diego, who co-authored the accompanying editorial with colleague, Murray Stein, M.D. (ANI)

New incision-free procedure raises hope for severe acid reflux patients

Washington, Mar 1 (ANI): Patients with severe, chronic acid reflux disease have been offered a new hope – a unique incision-free procedure called TIF, or transoral incisionless fundoplication.

Chronic GERD (gastroesophageal reflux disease) is a painful heartburn caused when stomach acid breaks through what is supposed to be a one-way valve – the lower esophageal sphincter (LES) – and reverses into the esophagus.

GERD can raise the risk of cancer of the esophagus, and can cause damage due to inhalation of stomach acid.

While most patients are prescribed a daily medication, it is sometimes ineffective. In addition, new research indicates that continued drug therapy might cause calcium depletion, contributing to osteoporosis.

“Drug therapy, when it works, is simply masking an underlying anatomic defect. The TIF procedure corrects the source of the problem by repairing the faulty lower esophageal sphincter in order to keep stomach acid where it belongs,” says Dr. Marc Bessler, director of laparoscopic surgery and director of the Center for Obesity Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center, and assistant professor of surgery at Columbia University College of Physicians and Surgeons.

The procedure is performed under general anesthesia and takes less than an hour.

The clinician inserts a specially-designed device through the patient’s mouth and into the stomach, just below the gastroesophageal junction, where tissue is molded to create a new valve.

“In most cases, the result is an elimination of reflux, with research showing that 80 percent of patients treated no longer need to take daily medications,” says Dr. Peter D. Stevens, director of endoscopy, director of interventional endoscopy and medical director of the scarless surgery program at NewYork-Presbyterian Hospital/Columbia University Medical Center, and associate professor of medicine at Columbia University College of Physicians and Surgeons.

“Because there are no incisions, the TIF procedure is more comfortable for the patient than the traditional open or laparoscopic approach, with a shorter hospital stay, improved recovery, and reduced risk of complications compared with open or laparoscopic surgery,” adds Dr. Stevens.

“Unlike prior endoscopic treatments for reflux, the molding of the flap valve that holds back acid is expected to be much more robust and effective,” the expert added. (ANI)

Mediterranean diet could cut Alzheimer’s risk

Washington, Feb 10 (ANI): A diet loaded with fish, olive oil, veggies and other foods common in Mediterranean-style cuisine can protect the brain against developing Alzheimer’s and other memory problems, says a new study.

According to a report in the February issue of Archives of Neurology, one of the JAMA/Archives journals, eating a Mediterranean diet appears to be associated with less risk of mild cognitive impairment-a stage between normal aging and dementia-or of transitioning from mild cognitive impairment into Alzheimer’s disease.

To reach the conclusion, Nikolaos Scarmeas, M.D., and colleagues at Columbia University Medical Center, New York, calculated a score for adherence to the Mediterranean diet among 1,393 individuals with no cognitive problems and 482 patients with mild cognitive impairment.

Participants were originally examined, interviewed, screened for cognitive impairments and asked to complete a food frequency questionnaire between 1992 and 1999.

Over an average of 4.5 years of follow-up, 275 of the 1,393 who did not have mild cognitive impairment developed the condition.

Compared with the one-third who had the lowest scores for Mediterranean diet adherence, the one-third with the highest scores for Mediterranean diet adherence had a 28 percent lower risk of developing mild cognitive impairment and the one-third in the middle group for Mediterranean diet adherence had a 17 percent lower risk.

Among the 482 with mild cognitive impairment at the beginning of the study, 106 developed Alzheimer’s disease over an average 4.3 years of follow-up.

Adhering to the Mediterranean diet also was associated with a lower risk for this transition. The one-third of participants with the highest scores for Mediterranean diet adherence had 48 percent less risk and those in the middle one-third of Mediterranean diet adherence had 45 percent less risk than the one-third with the lowest scores.

The Mediterranean diet may improve cholesterol levels, blood sugar levels and blood vessel health overall, or reduce inflammation, all of which have been associated with mild cognitive impairment.

Individual food components of the diet also may have an influence on cognitive risk. (ANI)