Serum sodium level is a major predictor of a poor prognosis for heart failure patients

Findings presented at ACC Scientific Sessions show improving serum sodium levels may improve outcomes -


Research presented today at the American College of Cardiology's Scientific Sessions in Orlando pinpoints a major marker of a
poor prognosis for heart failure, hyponatremia, or a lower than normal concentration of serum or blood sodium. Researchers
found that hyponatremia, which is found in almost a quarter of patients with severe heart failure, doubled death rates within
60 days of hospital discharge. Serum sodium levels are easily measured through routine blood tests.


"Even a minor decrease in a person's serum sodium level - levels that are now dismissed by physicians - had a major impact on
mortality of heart failure patients," says Mihai Gheorghiade, MD, associate chief, Division of Cardiology, Northwestern
Memorial Hospital and Northwestern University Feinberg School of Medicine, and lead presenter of the findings from the ESCAPE
trial during a poster session on Monday.


Heart failure is a major health threat in this country, resulting in 1 million hospital admissions each year. "These findings
illustrate that not all heart failure is created equally - heart failure accompanied with hyponatremia is especially
dangerous. Levels of serum sodium may prove a useful and easily accessible risk assessment tool in the clinical management of
patients hospitalized for heart failure," says Dr. Gheorghiade.


The good news is that a separate study presented Monday by Dr. Gheorghiade showed that improvement in sodium serum levels
during hospitalization was associated with improved outcomes. In the ACTIV trial, patients with a serum sodiuim improvement
at hospital discharge had a 15.6 percent mortality rate at 60 days post discharge, compared with a 30.4 percent mortality
rate in those showing no improvement. "Currently, the medical community is not paying much attention to serum sodium levels
in heart failure patients. However, serum sodium appears to be a modifiable target that can be treated," says Dr.
Gheorghiade.


A paper authored by Dr. Gheorghiade and published in JAMA in April of 2004 found that the medication tolvaptan was a
promising addition to standard therapy for patients hospitalized with heart failure. In addition to reducing fluid buildup
and decreasing body weight, tolvaptan improved serum sodium levels in patients with hyponatremia. "This is important because
previously, we have not had very effective therapies for treating hyponatremia in patients with heart failure. Now, we think
it can be treated, and we have an understanding that treating it can make a huge difference for the patient," says Dr.
Gheorghiade.


Sodium is an electrolyte that helps with nerve and muscle function, and also helps to maintain blood pressure. Hyponatremia
most commonly occurs in people whose kidneys do not function properly, as well as in those with heart failure, cirrhosis of
the liver, and Addison's disease. Sodium must be maintained at a specific concentration in the blood and the fluid
surrounding the body's cells for the body to function properly.















About Northwestern Memorial Hospital


Northwestern Memorial Hospital is one of the country's premier academic medical centers and is the primary teaching hospital
of Northwestern University's Feinberg School of Medicine. Northwestern Memorial and its Prentice Women's Hospital and Stone
Institute of Psychiatry have 744 beds and more than 1,200 affiliated physicians and 5,000 employees. Providing
state-of-the-art care, Northwestern Memorial is recognized for its outstanding clinical and surgical advancements in such
areas as cardiothoracic and vascular care, gastroenterology, neurology and neurosurgery, oncology, organ and bone marrow
transplantation, and women's health.


Northwestern Memorial was ranked as the nation's 5th best hospital by the 2002 Consumer Checkbook survey of the nation's
physicians and is listed in the majority of specialties in this year's US News & World Report's issue of "America's Best
Hospitals." The hospital is also cited as one of the "100 Best Companies for Working Mothers" by Working Mother magazine and
has been chosen by Chicagoans year after year as their "most preferred hospital" in National Research Corporation's annual
survey.


About the Bluhm Cardiovascular Institute


The Bluhm Cardiovascular Institute at Northwestern Memorial Hospital is a world-class heart program offering comprehensive
services and state-of-the-art surgical treatments in all areas of cardiovascular care. Recently named by Solucient, an
industry-leading healthcare information provider, as the only Chicago hospital on its list of the country's 100 Top
Cardiovascular Hospitals, Northwestern Memorial Hospital offers a timely response to referrals and a multidisciplinary
approach that joins physicians, nurses and a range of other medical specialists and caregivers from Cardiology, Cardiac
Surgery, Vascular Surgery, Cardiovascular Anesthesiology and Radiology from evaluation to follow-up. Patients benefit from
the latest minimally invasive surgical techniques and are offered the opportunity to participate in a range of clinical
research trials.


Advanced Cardiovascular Care


Patients referred to the Bluhm Cardiovascular Institute experience a healthcare environment in which the most advanced
diagnostic and treatment options are supported by state-of-the-art technology and a commitment to medical excellence through
research. Expertise is available in all areas of cardiovascular care, including:


Cardiac Surgery


-- Valve repair and replacement

-- MAZE and atrial fibrillation ablation procedures

-- Coronary artery bypass with arterial conduits

-- LV and aortic aneurysm repair

-- Congestive heart failure surgery

-- Ventricular assist devices


Vascular Surgery


-- Thoracic and abdominal aortic aneurysm surgery

-- Carotid endarterectomy and stents

-- Endovascular surgery for aortic aneurysms and limb salvage
-- Lower extremity bypass procedures

-- Uncommon mesenteric and upper extremity revascularization
-- Supraaortic trunk revascularization


Cardiology


-- Primary and secondary prevention

-- Advanced diagnostic testing including echocardiography, nuclear cardiology, cardiac MRI and computed tomography

-- Cardiac electrophysiology, including diagnostic EP procedures, catheter ablation and pacemaker and ICD implantation

-- Heart failure management

-- Evaluation of heart valve disease

-- Acute coronary care

-- Diagnostic catheterization and interventional cardiology


Contact: Amanda Widtfeldt

awidtfelnmh

312-926-2955

Northwestern Memorial Hospital

nmh

Study Locates Cholesterol Genes; Finds Surprises About Good, Bad Cholesterol

An international study of 20,000 people found seven new genes that influence blood cholesterol levels, a major factor in heart disease, and confirmed 11 other genes previously thought to influence cholesterol.



The international study led by researchers from the University of Michigan School of Public Health set out to identify or confirm genetic variants that influence lipid levels, and secondly, to see if those variants were linked to the decreased or increased risk of heart disease. The findings were published online in the journal Nature Genetics on Jan. 13.



The results may lead the medical community to rethink the role of HDL (good cholesterol) and LDL (bad cholesterol) in heart disease, said Goncalo Abecasis, associate professor in the U-M School of Public Health. Abecasis co-directed the study with Karen Mohlke, assistant professor of genetics at the University of North Carolina at Chapel Hill School of Medicine.



"It was surprising that while genetic variants that increase your bad cholesterol are also associated with increased risk of heart disease, we did not find that variants influencing your good cholesterol were associated with decreased risk of coronary artery disease. Perhaps that result will lead us to reexamine the roles of good and bad cholesterol in susceptibility to heart disease," Abecasis said.



Coronary artery disease, a condition where plaque accumulates on the walls of coronary arteries, is the most common type of heart disease and a leading cause of death in industrialized countries. The type and amount of cholesterol and other lipids in the bloodstream contribute to the risk of coronary artery disease, which can cause heart attack, stroke, angina and other heart conditions. Both genetic and environmental factors influence a person's cholesterol and blood lipid levels.



"Finding new gene regions associated with cholesterol levels may bring us one step closer to developing better treatments, said Cristen Willer, co-first author and a research fellow in the Department of Biostatistics. "Nearly all of the gene regions that we found to be involved in higher LDL levels were also involved in coronary artery disease risk. This is a remarkable result and suggests that new drug therapies that target the genes in these regions will also help prevent coronary artery disease and allow people to live longer and healthier lives." Serena Sanna, who worked on the paper as a post-doctoral student in Abecasis' group and who is now at the National Research Council di Cagliari in Italy, is co-first author.
















Of the seven new variants, two influenced HDL, one influenced LDL, and three influenced triglycerides, which are found in fat and in the bloodstream and like LDL, are associated with increased risk of heart disease. One variant influenced triglycerides and LDL.



Scientists initially examined 2 million genetic variants in 8,800 individuals and ended up focusing on a total of 25 genetic variants on 18 genes. Altogether the variations reported are responsible for less than a quarter of the genetic contributions to lipid levels.



The completion of the map of human genetic variation, or HapMap, has fueled a surge in this type of genome-wide association study, with most of the growth coming in the past 10 months. Researchers around the globe have now associated more than 60 common DNA variants with the risk of more than 20 common diseases or related traits.







The research received major support from the National Human Genome Research Institute, National Institute on Aging, National Institute of Diabetes and Digestive and Kidney Diseases, and the National Heart, Lung and Blood Institute, all of which are part of the National Institutes of Health; the American Diabetes Association; the Department of Veterans Affairs; the British Heart Foundation; the United Kingdom's Medical Research Council; and the French Ministry of Higher Education and Research.



For more on Abecasis, visit: sph.umich/csg/abecasis/.



For more on the U-M School of Public Health, visit: sph.umich/.



The University of Michigan School of Public Health has been working to promote health and prevent disease since 1941, and is consistently ranked among the top five public health schools in the nation. Faculty and students in the school's five academic departments and dozens of collaborative centers and initiatives are forging new solutions to the complex health challenges of today, including chronic disease, health care quality and finance, emerging genetic technologies, climate change, socioeconomic inequalities and their impact on health, infectious disease and the globalization of health. Whether making new discoveries in the lab or researching and educating in the field, our faculty, students and alumni are deployed around the globe to promote and protect our health.

Cardiologists/Cardiothoracic Surgeons Form Medical Society Focusing on Heart Valve Disease

The Heart Valve Society of America (HVSA) - including the Heart Valve Trialists Society - has been formed by a founding
board of nationally and internationally prominent cardiologists and cardiothoracic surgeons in the heart valve disease field.



The mission of the Society is to:


- promote research


- educate medical professionals about the evaluation and treatment of heart valve diseases;


- serve as an informational resource for government, private industry, healthcare providers, the media and public; and,



- encourage and facilitate education of future heart valve disease specialists


"Heart valve diseases can be considered 'mystery killers,'" said Jeffrey S. Borer, MD of Weill Medical College of Cornell
University, president of the Society. "Too often, they progress slowly and imperceptibly, yet are capable of causing sudden
and unexpected death. The founding board believes a vehicle is needed to bring cardiologists, cardiothoracic surgeons,
anesthesiologists, pathologists, internists, basic scientists, other medical and allied health professionals together, in
order to further research and educate caregivers and patients about this important public health problem."


Please visit our site at heartvalvesocietyofamerica


The founding board members include:


Jeffrey S. Borer, MD (President) - Gladys & Roland Harriman Professor of Cardiovascular Medicine, Chief, Division of
Cardiovascular Pathophysiology and Co-director, The Howard Gilman Institute for Valvular Heart Diseases, Weill Medical
College of Cornell University


Maurice E. Sarano, MD (Executive Vice President) - Professor of Medicine, Mayo Medical School; Director, Valvular Heart
Disease Clinic, Mayo Clinic


A. Jamil Tajik, MD (Secretary) - Thomas J. Watson, Jr. Professor, Mayo Medical School; Consultant, Cardiovascular Diseases,
Mayo Clinic


Mark Starling, MD (Treasurer) - Medical Director, Banner Baywood Heart Hospital, Mesa, AZ


Cary W. Akins, MD (Vice President/Interspecialty Liaison) - Clinical Professor of Surgery, Harvard Medical School; Chief,
Division of Cardiac Surgery, Massachusetts General Hospital


Robert O. Bonow, MD (Vice President/Membership) - Goldberg Distinguished Professor of Medicine and Chief, Division of
Cardiology, Northwestern University Medical School; immediate past president, American Heart Association


Blase Carabello, MD (Vice President/Programs & Education) - The W.A. "Tex" and Deborah Moncrief Jr. Professor of Medicine,
Baylor College of Medicine; Vice Chairman, Department of Medicine, Baylor College of Medicine


O. Wayne Isom, MD (Vice President/Interspecialty Liaison) - Terry Allen Kramer Professor and Chairman, Department of
Cardiothoracic Surgery and Co-Director, The Howard Gilman Institute for Valvular Heart Diseases, Weill Medical
College


Jagat Narula, MD (Vice President/Policy) - Professor of Medicine, Chief of Cardiology, Associate Dean, University of
California/Irvine


Since receiving its nonprofit status in late October 2004, HVSA membership has grown to close to 200 members. In April, the
Society had it first annual meeting and conference at Valves in the Heart of the Big Apple IV: Evaluation & Management of
Valvular Heart Diseases 2005 in New York City. Almost 350 participants from the US and abroad attended the two and one-half
day conference, which featured top presenters in the field.


Membership is open to medical and allied health professionals involved/interested in the field, as well as individuals who
work for corporations, academic and service institutions, and foundations interested in valvular heart disease.


Leslie J. Yerman

Company Name: Heart Valve Society of America

Email: HVSA2004yahoo

Phone: 212-327-2107

heartvalvesocietyofamerica

Boston Scientific Welcomes Publication Of Analysis Of Patients Monitored By The LATITUDE® Patient Management System

Boston Scientific Corporation (NYSE: BSX) welcomed the publication of an analysis from its ALTITUDE® Clinical Science program in the current issue of Circulation that showed patients followed by the LATITUDE® Patient Management system experienced a 50 percent relative reduction in the risk of death compared to patients followed in-clinic only. The analysis also showed that heart failure patients who transmitted weight and blood pressure data via the LATITUDE system experienced an additional 10 percent reduction in the risk of death compared to other CRT-D patients followed by the LATITUDE system.


Boston Scientific has enrolled more than 180,000 patients on the LATITUDE system since its introduction in 2006. The LATITUDE system enables physicians to conduct remote follow-up of implantable cardiac device patients to monitor specific device information and heart health status. The system can also detect clinical events between scheduled in-clinic visits and send relevant data directly to physicians.


The ALTITUDE program enhances physician understanding of device therapy, outcomes and disease progression in a real-world setting for device patients followed by the LATITUDE system.


"Patients remotely monitored by physicians may fare better due to earlier notification of events, resulting in diagnosis or therapy that can reduce subsequent risk," said Leslie Saxon, M.D., F.A.C.C., Chief, Cardiovascular Medicine at the Cardiovascular and Thoracic Institute, University of Southern California, and chairperson of the ALTITUDE physician panel. "Remote follow-up may also encourage patients to be more aware of their health status."


Cautionary Statement Regarding Forward-Looking Statements


This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking statements may be identified by words like "anticipate," "expect," "project," "believe," "plan," "estimate," "intend" and similar words. These forward-looking statements are based on our beliefs, assumptions and estimates using information available to us at the time and are not intended to be guarantees of future events or performance. These forward-looking statements include, among other things, statements regarding new product launches and launch cadence, regulatory approvals, clinical trials, product performance and competitive offerings. If our underlying assumptions turn out to be incorrect, or if certain risks or uncertainties materialize, actual results could vary materially from the expectations and projections expressed or implied by our forward-looking statements. These factors, in some cases, have affected and in the future (together with other factors) could affect our ability to implement our business strategy and may cause actual results to differ materially from those contemplated by the statements expressed in this press release. As a result, readers are cautioned not to place undue reliance on any of our forward-looking statements.


Factors that may cause such differences include, among other things: future economic, competitive, reimbursement and regulatory conditions; new product introductions; demographic trends; intellectual property; litigation; financial market conditions; and, future business decisions made by us and our competitors. All of these factors are difficult or impossible to predict accurately and many of them are beyond our control. For a further list and description of these and other important risks and uncertainties that may affect our future operations, see Part I, Item 1A Risk Factors in our most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission, which we may update in Part II, Item 1A Risk Factors in Quarterly Reports on Form 10-Q we have filed or will file hereafter. We disclaim any intention or obligation to publicly update or revise any forward-looking statements to reflect any change in our expectations or in events, conditions or circumstances on which those expectations may be based, or that may affect the likelihood that actual results will differ from those contained in the forward-looking statements. This cautionary statement is applicable to all forward-looking statements contained in this document.

Medtronic Launches First Insertable Cardiac Monitor In Japan

Medtronic, Inc. (NYSE: MDT) announced it has received Japanese regulatory approval for the Reveal DX™ Insertable Cardiac Monitor (ICM). The device has been designated by the Japanese government as a high-priority medical device, and is the first insertable cardiac monitor to be introduced in Japan.


The Reveal DX ICM provides insight into unexplained fainting episodes, also known as syncope. Syncope is difficult to diagnose as episodes are often too infrequent and unpredictable for detection with conventional monitoring techniques such as ECG Holter monitors or external loop recorders. These tests are limited to 24 hours and one month, respectively; combined with the constraints placed on the patient's daily life and the limited likelihood of an event occurring during the monitoring period, the testing may fail to determine the cause of the episodes.


Inserted just under the skin of the chest area, the Reveal DX ICM is approximately the size of a memory stick; it is capable of monitoring patients for up to three years, allowing for long-term, continuous cardiac monitoring. Records of arrhythmias are automatically recorded and saved, and patients may prompt the device to record any events at any time. If the patient experiences a syncopal episode, the information collected by the device may help the physician determine if the episode is attributable to an arrhythmia.


Since no similar device has been available in Japan, the Ministry of Health, Labor and Welfare designated the Reveal DX as "high priority" for approval in Japan. The device was subject to a fast-track evaluation by the Japanese government, and received regulatory approval in July 2008.


Medtronic Japan will begin marketing the Reveal DX ICM once it has attained insurance reimbursement for the device. The company will partner with Asahi Kasei for exclusive sales distribution rights for the device in Japan; Medtronic Japan will serve as the device's designated Marketing Authorization Holder.



The Reveal DX ICM is also commercially available in the United States, Western Europe and Canada.


About Syncope Causes of syncope can be heart rhythm disturbances or abnormalities in the structure of the heart. Syncope can lead to serious injury or can be a precursor to sudden cardiac death. Approximately 1.5 million people worldwide suffer from unexplained syncope. In almost 10 percent of patients, syncope has a cardiac cause (in 50 percent of cases, the cause is non-cardiac; and in 40 percent of cases the cause is unknown1).



??E.S. Soteriades et al. N Eng J Med. 2002; 347 (12):878-885


About Medtronic


Medtronic, Inc., headquartered in Minneapolis, is the world's leading medical technology company, alleviating pain, restoring health and extending life for people with chronic disease. Its Internet address is medtronic.



About Medtronic Japan


Medtronic therapies cover a wide range of afflictions, from cardiac diseases to Parkinson's disease, diabetes, spinal disorders, cerebral disorders, chronic pain other chronic conditions. Medtronic Japan was founded in 1975 and has spent more than 30 years alleviating pain and restoring life for Japanese patients suffering from chronic diseases. Web site: medtronic.co.jp


About Asahi Kasei


Asahi Kasei provides innovative solutions based in chemistry and materials science to a diverse range of markets including fibers, chemicals, consumer products, housing, construction, electronics, and health care. Web site: asahi-kasei.co.jp/asahi/jp/index.html


Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's Annual Report on Form 10-K for the year ended April 25, 2008. Actual results may differ materially from anticipated results.

medtronic

Heart Attack Patients At Higher Risk Of Onset Of Diabetes

People who have had heart attacks are at higher risk of developing both new-onset diabetes and the pre-diabetes condition impaired fasting glucose (IFG), conclude authors of an Article published in this week's edition of The Lancet.

Dr Dariush Mozaffarian, Harvard Medical School and Harvard School of Public Health, Boston, USA, Dr Roberto Marchioli, Consorzio Mario Negri Sud, Italy and colleagues studied 8291 Italian patients who had had a heart attack within the previous three months, and were free of diabetes. Incidence of new-onset diabetes and IGF were measured at 0???5, 1???0, 1???5, 2???5, and 3???5 years follow-up. Data for body-mass index, other risk factors, dietary habits, and medications were updated during the follow up, and a Mediterranean diet score was given to each patient based on their consumption of raw and cooked vegetables, fruit, fish and olive oil.


The researchers found one third of patients with a recent heart attack developed diabetes or IFG (blood glucose 6???1 mmol/L or more), during the 3???5 years of follow up; this rose to two-thirds when the lower IFG cut-off point of 5???6 mmol/L or more blood glucose was used. Patients with a recent heart attack were up to four-and-a-half times more likely to develop diabetes (3???7%) compared with the general population (0???8-1???6%), and more than 15 times more likely to develop IFG (27???5% versus 1???5%).


Independent risk factors associated with new-onset diabetes or IFG included older age, high blood pressure, use of beta-blockers, lipid-lowering medications (protective), and diuretic use. Independent life-style risk factors included higher body mass index (BMI), greater BMI gain during follow-up, current smoking (which increased risk by 60%), a lower Mediterranean dietary score, and wine consumption of more than one litre per day. Data for physical activity were unavailable, but people who could not perform exercise testing were at higher risk of both diabetes and IFG.


The authors conclude: "Our findings suggest that incidence of IFG and diabetes is high in the years after myocardial infarction, suggesting that acute myocardial infarction could be a pre-diabetes risk-equivalent??¦Our findings also suggest that smoking cessation, prevention of weight gain, and consumption of typical Mediterranean foods could substantially lower this risk, which has important implications for counselling patients soon after they have a myocardial infarction - an opportune time to institute lifestyle changes in patients motivated by a life-changing event."


In an accompanying Comment, Dr Lionel Opie, Hatter Cardiovascular Research Institute, University of Cape Town, South Africa, says: "These findings further tie the knot between myocardial infarction and hyperglycaemia - each causes the other." He adds that, of the lifestyle factors, "major interest lies in the potential protective effect of the Mediterranean diet."


thelancet

3rd Annual Cardiometabolic Health Congress, Boston

The 2008 Cardiometabolic Health Congress (CMHC) will hold its third annual meeting October 15-18, 2008, at the Sheraton Boston Hotel. Over 1,000 clinicians will attend educational sessions focusing on cardiometabolic risk, including the prevention and management of diabetes, obesity, hypertension, atherosclerosis, dyslipidemia, and chronic kidney disease. The CMHC agenda, faculty, and general congress information can be found at cardiometabolichealth.


The congress will evaluate novel and emerging therapies that combat the epidemic of obesity, diabetes, and cardiovascular disease. CMHC features over 50 world-renowned experts translating cutting-edge science into practical approaches to manage the problems associated with metabolic syndrome and cardiovascular risk. Physicians and allied health professionals can earn up 37.5 continuing medical education credits.


"The management of diabetes is evolving quickly, with new therapeutic agents and several landmark studies reporting this year," said John Buse, MD, PhD, CDE, chief of the Division of Endocrinology at the University of North Carolina School of Medicine at Chapel Hill. "Discussing these advances in the context of cardiovascular risk management is critical for establishing best practices in patient care."


The CMHC late-breaking clinical trials data session will provide healthcare professionals with the most recent findings from large, ongoing clinical trials and discuss how the data will impact their practice.


"Cardiometabolic (CM) risk is the new paradigm that challenges us to understand patients' risk for developing cardiovascular disease and diabetes. The 2008 CMHC is the place to hear all the latest information on CM risk," said Christopher Cannon, MD, senior investigator in the TIMI Study Group at Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School.


An unprecedented group of prestigious medical organizations, including the American Diabetes Association, the American Heart Association (Councils on Clinical Cardiology; Atherosclerosis, Thrombosis, and Vascular Biology; High Blood Pressure Research; Cardiovascular Nursing; Epidemiology and Prevention; and Nutrition, Physical Activity, and Metabolism); the Endocrine Society; the American Society of Hypertension, and the National Kidney Foundation, among many others, have been supporting CMHC for the past three years.


The 2008 CMHC is co-chaired by Christie M. Ballantyne, MD; Robert H. Eckel, MD; Richard W. Nesto, MD; and Jay S. Skyler, MD.


Cardiometabolic Health