Family Practice News articles from June 2006

Family Practice News archives from June 2006

Outbreak fortifies MMR schedule.(Measles-mumps-rubella )(Disease/Disorder overview)
June 15, 2006... All health care workers should receive two doses of the measles-mumps-rubella vaccine if they don't have evidence of immunity, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention voted during a...

'Gastroprotection gap' exposes NSAID users.
June 15, 2006... Los Angeles -- The market withdrawal of selective cyclooxygenase-2 inhibitors due to concerns about their associated cardiovascular risks has created a "gastroprotection gap" among elderly patients with arthritis who require NSAIDs, Dr....

Moderate drinking beats teetotalism on associated colorectal cancer risk.(News)(Brief article)
June 15, 2006... Los Angeles -- Individuals who consume moderate amounts of alcohol have a lower risk of developing colorectal adenomas compared with heavy drinkers, according to research presented at the annual Digestive Disease Week. Furthermore,...

HPV prevalence peaks in 14- to 19-year-olds.(News)(human papillomavirus)
June 15, 2006... Jacksonville, Fla. -- The prevalence of high-risk human papillomavirus in U.S. women is highest in the 14 to 19-year-old age group, according to a presentation at an STD prevention conference sponsored by the Centers for Disease Control and...

Cardiac risks persist after rofecoxib cessation.(News)
June 15, 2006... To minimize the danger of a heart attack or stroke, patients who have previously taken rofecoxib should receive daily low-dose aspirin and ongoing cardiovascular monitoring, experts say. These patients appear to be at increased risk of...

Minimal acetaminophen amounts pose risks in hepatitis.(News)(Brief article)(Clinical report)
June 15, 2006... Los Angeles -- Even small amounts of acetaminophen can cause acute liver failure and death in some patients with acute viral hepatitis, according to research presented at the annual Digestive Diseases Week. Acetaminophen adducts--the...

Hepatic events associated with Ketek investigated.(News)
June 15, 2006... As a Senate committee delves further into an investigation of approval of and postmarketing experience with the antibiotic Ketek, the Food and Drug Administration reportedly has compiled a growing number of cases of severe liver toxicity...

Promethazine contraindicated under age 2 years.(News)(Brief article)
June 15, 2006... The Food and Drug Administration has issued a safety warning to alert health care professionals that promethazine HC1 in all forms, including syrup, is contraindicated in children younger than 2 years of age. Caution is also advised when...

Multivitamin benefits scrutinized by NIH panel.(News)
June 15, 2006... Bethesda, Md. -- Evidence of the effectiveness and safety of multivitamin and mineral supplements to prevent chronic diseases is too sparse and ambiguous to recommend for or against their use, according to a panel of experts at a conference...

History, lifestyle factors contribute to ulcerative colitis.(News)(Brief article)
June 15, 2006... Los Angeles -- Former smokers and people with a family history of inflammatory bowel disease are at increased risk for developing ulcerative colitis, data from a case-control study of more than 1,400 patients have confirmed. Family...

New sexually transmitted disease treatment guidelines forthcoming.(News)
June 15, 2006... Boston -- The soon-to-be-released 2006 STD treatment guidelines from the Centers for Disease Control and Prevention likely will include new recommendations for the diagnosis or treatment of gonorrhea, bacterial vaginosis, tri: chomoniasis,...

Smoking cessation Rx curbs cravings, blocks nicotine's effect.(News)
June 15, 2006... The newly approved drug varenicline may help a significantly higher percentage of patients quit smoking than bupropion, according to Food and Drug Administration officials and others. The drug was judged from early trials to show such...

Counseling is key to smoking cessation.(Column)
June 15, 2006... If history is any guide, the introduction of Chantix will be a much ballyhooed new addition to the smoking cessation arsenal. In nearly 30 years as a family physician and an active participant in the effort to curb tobacco use, I have...

Aggressive use of statins lowers post-ACS mortality.(Cardiovascular Medicine)(Acute Coronary Syndrome)(Clinical report)
June 15, 2006... Chicago -- Initiating high-dose statin therapy during hospitalization for an acute coronary syndrome brings significant survival benefit, Dr. Anthony A. Bavry said at the annual meeting of the Society for Cardiovascular Angiography and...

Valsartan cuts CRP levels, lowers blood pressure.(Cardiovascular Medicine)(C-reactive protein)(Drug overview)(Clinical report)
June 15, 2006... New York -- Monotherapy with valsartan has been shown for the first time to lower serum levels of C-reactive protein, raising the possibility that valsartan--and possibly other antihypertensive agents--might have a beneficial effect on...

More aggressive secondary CHD prevention urged: new guidelines recommend tighter management of pharmacologic therapies and key risk factors.(Chronic Heart Disease)(Disease/Disorder overview)
June 15, 2006... Updated secondary prevention guidelines pull together the latest data from clinical trials to advocate more aggressive management of patients with coronary heart disease. The American Heart Association/American College of Cardiology...

Heart symptoms prior to MI missed in primary care settings.(Myocardial infarction )(Clinical report)
June 15, 2006... Los Angeles -- Nearly one in nine patients admitted with an acute MI was seen shortly before the MI in the primary care setting with symptoms suggestive of acute cardiac ischemia, Dr. Thomas D. Sequist reported at the annual meeting of the...

Urban youth rarely screened for CVD, even when overweight: more than a quarter of the children turned out to be positive for hypertension, diabetes, or dyslipidemia.(Cardiovascular Disease)(Clinical report)
June 15, 2006... San Francisco -- Children aged 10-19 years in Boston were unlikely to be screened for cardiovascular disease risk factors even if they were overweight, according to a large retrospective chart review. Of 11,081 children, 33% had no family...

Subclinical atherosclerosis seen in inflammatory arthritis.(Disease/Disorder overview)
June 15, 2006... Glasgow, Scotland -- Subclinical atherosclerosis is common among patients early in the course of inflammatory polyarthritis, even among those not considered to be otherwise at high risk for cardiovascular disease, Diane K. Bunn reported at...

Fiber intake predicts CV disease risk in teens.(Cardiovascular Diseases)(Disease/Disorder overview)
June 15, 2006... San Francisco -- The amount of plant food adolescents eat is a better predictor of cardiovascular risk than is their intake of cholesterol or saturated fat, according to a poster presentation by Dr. Karen A. Ortiz at the annual meeting of the...

Pregnancy complications may flag premature coronary artery disease.(Disease/Disorder overview)
June 15, 2006... Atlanta -- Consider pregnancy complications to be a red flag for premature coronary artery disease, Dr. Mimi S. Biswas said at the annual meeting of the American College of Cardiology. She presented a retrospective cohort study involving...

Tool screens for latent autoimmune diabetes.(Metabolic Disorders)
June 15, 2006... A relatively simple screening tool helps determine whether patients who present with adult-onset diabetes have type 2 disease or latent autoimmune diabetes, according to Dr. Spiros Fourlanos and his associates at the Walter and Eliza Hall...

Clanging tuning-fork test zeros in on nondiabetic neuropathy.(Disease/Disorder overview)
June 15, 2006... Chicago -- Results of a tuning-fork test to identify neuropathy appear to be reproducible in a nondiabetic population, according to findings from a blinded, observational study. In a presentation at the annual meeting of the American...

Type 2 diabetes' effects on pregnancy underestimated.(Metabolic Disorders)(Brief article)
June 15, 2006... Hollywood, Fla. -- Women need to be better educated about the risks of type 2 diabetes in pregnancy, Dr. Erin Keely said at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. "Type 2 diabetes is at least as...

PM hypertension flags type 1 complications.(Metabolic Disorders)(Clinical report)
June 15, 2006... Chicago -- With the goal of preventing renal complications in type 1 diabetics, nephrologists have begun to focus on subtle increases in nighttime blood pressure as a risk factor for the subsequent development of overt nephropathy. "It...

Gender disparities dog type 2 care; women's CVD risks undertreated.(Type 2 diabetes )(Disease/Disorder overview)(Brief article)
June 15, 2006... Los Angeles -- Women with type 2 diabetes may be treated for dyslipidemia less aggressively than men, and therefore may be at higher risk of developing cardiovascular disease, Dr. Quyen Ngo-Metzger reported at the annual meeting of the...

CDC: influenza vaccine period will be extended.(Centers for Disease Control and Prevention )
June 15, 2006... Washington -- This winter's flu season is still months away, but officials from the federal government and the American Medical Association say they will be strongly urging physicians to extend influenza vaccine administration beyond its...

Logistics, financial barriers will stymie HPV vaccine's impact.(Human papillomavirus vaccine)
June 15, 2006... Jacksonville, Fla. -- Financial and logistic barriers will limit the implementation and impact of human papillomavirus vaccine, Dr. Lance Rodewald said at a conference on STD prevention sponsored by the Centers for Disease Control and...

Menactra in short supply; target high-risk groups.(Infectious Diseases)(Brief article)
June 15, 2006... College freshman living in dorms and adolescents entering high school are moving to the head of the line to receive Menactra, following an announcement from the manufacturer that the company won't be able to meet demand for the meningococcal...

Studies shed light on hepatitis C therapy combos, nonresponders.(Drug overview)
June 15, 2006... Los Angeles -- Extended combination therapy with consensus interferon for 72 weeks appears to help improve the viral response of patients with chronic hepatitis C who have previously relapsed after a 48-week course of treatment, according to...

Infections linked to mifepristone spur debate on proper use.(Fatal Clostridiura sordellii infections)(Drug overview)
June 15, 2006... Atlanta -- While the precise nature of the link between medical abortion and fatal toxic shock-like syndrome remains a mystery, the handful of case reports have prompted a difference in opinion about how such procedures should be carried Out....

Concurrent FluMist, MMR, varicella vaccines OK.(Measles-mumps-rubella)
June 15, 2006... San Francisco -- Physicians can administer the live attenuated influenza vaccine marketed as FluMist during the same healthy infant visit in which they administer the measles-mumps-rubella and varicella vaccines, without diminishing the...

Hormone combo cuts blood pressure, hot flashes.(Drug overview)
June 15, 2006... Washington -- The combination of drospirenone (a progestin with antialdosterone effects) and 17-[beta]-estradiol as hormone therapy for hypertensive postmenopausal women not only reduces their hot flashes, but lowers their blood pressure as...

ACOG advises initial ob.gyn. visit for 13- to 15-year-olds.(American College of Obstetricians and Gynecologists)
June 15, 2006... Washington -- Teenage girls should have their first visit with an ob.gyn. between the ages of 13 and 15, according to a recommendation from the American College of Obstetricians and Gynecologists. This initial visit should be focused on...

One-fourth of primigravidas suffer levator ani injury.(Disease/Disorder overview)
June 15, 2006... Tucson, Ariz. -- One woman in four suffers neuropathic injury to the levator ani with her first delivery according to a novel study that used pre- and postpartum concentric needle electromyographic examinations to study muscle function. ...

Frovatriptan relieves pure menstrual migraines.(Drug overview)
June 15, 2006... Washington -- Women who took 2.5 mg of frovatriptan either once or twice daily for 6 days at the time of menstruation had significantly fewer--and less severe-menstrual migraines, compared with women who took a placebo, reported Dr. Marie...

Perinatal risks increase with maternal weight.(Brief article)
June 15, 2006... Washington -- Either too much or too little weight gain during pregnancy could increase the risk of neonatal intensive care unit admission and peripartum complications, according to data presented at the annual meeting of the American College...

C-section rate rises, lacerations fall in tandem.(Brief article)(Clinical report)
June 15, 2006... Tucson, Ariz. -- The rate of anal sphincter laceration during vaginal delivery has sharply declined in recent years, paralleling modifications in obstetric practice, a University of Southern California study revealed. Anal sphincter...

Bromelain for osteoarthritis.(Drug overview)
June 15, 2006... History of Use Bromelain is a proteolytic enzyme present in the stem and fruit of the pineapple plant (Ananas comosus), which was encountered by Christopher Columbus in Guadaloupe during his second voyage to the Caribbean in 1493....

Closely monitor heart health in psoriasis patients: studies show elevated MI risk among patients with psoriasis; association decreases with age.(Clinical report)
June 15, 2006... Philadelphia -- There is mounting evidence that patients with psoriasis are at increased risk of cardiovascular disease, according to several large epidemiologic surveys presented at the annual meeting of the Society for Investigative...

Light-based therapy prevents radiation dermatitis: LED photomodulation helps avoid skin reactions, treatment interruptions in breast cancer patients.(Disease/Disorder overview)
June 15, 2006... Boston -- A light-based therapy commonly used in cosmetic dermatology minimizes the occurrence and symptom intensity of radiation-induced dermatitis in breast cancer patients undergoing radiation treatment, according to the results of a...

Duac gel advantageous in acne; prevents drying seen in BP alone.(Benzoyl peroxide)
June 15, 2006... Koloa, Hawaii -- Duac, a clindamycin l%/benzoyl peroxide 5% topical gel containing moisturizers and humectants, offers several advantages for topical acne therapy, Dr. Leon H. Kircik said at the annual Hawaii dermatology seminar sponsored by...

Acne treatment shifting from antibiotics toward retinoids.(Drug overview)
June 15, 2006... San Francisco -- Prescribing has been gradually moving away from antimicrobial agents and toward increased use of retinoids in the treatment of acne vulgaris. The shift toward nonantibiotics, reported in an analysis of national...

Evidence-based mnemonic clarifies suicide risk.(Clinical report)
June 15, 2006... Seattle -- An American Association of Suicidology expert consensus panel has developed the first evidence-based list of warning signs for suicide--and fashioned a mnemonic designed to help get out the message. Here's the mnemonic, which...

Screen select athletic patients for depression and panic disorder.(Brief article)
June 15, 2006... Miami -- Athletic patients with significant musculoskeletal pain should be screened for comorbid depression and panic disorder, according to study findings presented at the annual meeting of the American Medical Society for Sports Medicine....

Suicide risk in young adults taking paroxetine warrants close monitoring.(Drug overview)
June 15, 2006... Paroxetine may increase the risk of suicidal behavior in adults, particularly in young adults, findings from a recent metaanalysis suggest. "It is therefore important that all patients, especially young adults and those who are...

Physician substance abusers spur Tx research.(Clinical report)
June 15, 2006... San Diego -- Drug abuse treatment has a fairly dismal success rate among most groups, with one notable exception: physicians. Now, a group of experts wants to find out what it is about doctors or the assistance they receive that is so...

Few kids achieve asthma control, despite Tx.(Pulmonary Medicine)
June 15, 2006... San Francisco -- A study of 975 asthmatic children in four states found only one child in five achieved optimal symptom control through use of preventive medication. While 37% of the symptomatic children did not use any preventive...

Cochrane panel: corticosteroids achieve best asthma control.(Drug overview)
June 15, 2006... Inhaled corticosteroids are better than sodium cromoglycate in measures of lung function and asthma control in children and adults with chronic asthma, the first-ever systematic review of its kind has concluded. "The results suggest that...

Chart stickers prompt asthma severity assessment, better care.(Disease/Disorder overview)
June 15, 2006... San Francisco -- A small intervention had a sizable impact on documentation of asthma severity and appropriate treatment of children at an inner-city health center, according to results of a randomized controlled trial reported in a poster at...

Laparoscopic Nissen fundoplication beats Rx.(Disease/Disorder overview)
June 15, 2006... Los Angeles -- Laparoscopic Nissen fundoplication is superior to medication for overall symptom control in patients with gastroesophageal reflux disease, according to preliminary research results presented at the annual Digestive Disease...

Nonalcoholic fatty liver emerging as major health burden in the U.S.(Disease/Disorder overview)
June 15, 2006... Philadelphia -- Nonalcoholic fatty liver disease is emerging as a major health burden in the United States, Dr. K. Rajender Reddy said at the annual meeting of the American College of Physicians. Often associated with obesity and...

GERD surgery is still an option for select patients, expert says.(Gastroesophageal reflux disease)(Clinical report)
June 15, 2006... Dallas -- The steep decline in antireflux surgery since the 1990s may be caused by skepticism following publication of a study suggesting that most patients who undergo surgery eventually resume taking antireflux medication, said Dr. Jonathan...

Age should not hinder gastric bypass candidacy.(Clinical report)
June 15, 2006... Los Angeles -- Both seniors and adolescents can be good candidates for Roux-en Y gastric bypass surgery, according to new research presented at the annual Digestive Disease Week. In a review of 167 surgical cases at the Mayo Clinic in...

Severe Alzheimer's responds to donepezil.(Drug overview)
June 15, 2006... Chicago -- Patients with severe Alzheimer's disease showed improved cognition and function when treated with donepezil in a 24-week, placebo-controlled trial, Dr. Sandra Black and her associates reported in a poster at the annual meeting of...

Ritalin lifted dementia-related Apathy in a 13-patient study.(Drug overview)
June 15, 2006... Chicago -- Methylphenidate may be effective in the treatment of apathy associated with dementia of the Alzheimer type, Dr. Prasad Padala and associates reported in a poster at the annual meeting of the American Geriatrics Society. ...

Dementia.(Clinical Guidelines )(Disease/Disorder overview)
June 15, 2006... A person who has progressive dementia experiences decline in multiple areas of cognitive function, and eventually manifests significant deficits, usually beginning in occupational function, progressing to social function, and eventually...

Alfuzosin slows progression of benign prostatitis.(Drug overview)
June 15, 2006... Paris -- The [alpha]-1 blocker alfuzosin prevented overall clinical progression of benign prostatic hyperplasia but had no impact on acute urinary retention in a 2-year, double-blind, placebo-controlled, multi-national study that enrolled...

Unnecessary PSA screening of elderly men occurs often.(Prostate Specific Antigen )(Clinical report)
June 15, 2006... Chicago -- Despite recommendations to the contrary, prostate-specific antigen screening is being performed in many elderly men who are not in good health and have limited life expectancies. That conclusion was drawn from an analysis of...

Three-year testosterone regimen didn't improve cognition in healthy older men.(Clinical report)
June 15, 2006... Chicago -- Exogenous testosterone, taken either alone or with finasteride for 36 months, did not significantly improve cognition in a randomized, placebo-controlled trial involving healthy older men. The findings do little to settle the...

Hip protectors fail to reduce fracture rates.
June 15, 2006... Chicago -- The first randomized controlled trial of hip protectors in U.S. nursing home residents was unable to detect a protective effect, even in residents with high compliance. Studies that were conducted in Europe and Asia have...

Motorized pacifier gets preterm neonates to suck.
June 15, 2006... San Francisco -- Its official name is the N-Trainer, but Steven M. Barlow, Ph.D., suggested thinking of the new device as a "motorized pacifier" that teaches preterm neonates how to suck. The N-Trainer worked so well for 10 preterm...

Toilet-training relapses 101: get to the heart of the problem.
June 15, 2006... Washington -- It's not uncommon for children to go through a relapse period with toilet training, and the trick to management may just be for everyone to lighten up, according to one expert speaking at a meeting sponsored by the American...

Warfarin-related interactions top adversity list.(Drug overview)
June 15, 2006... Philadelphia -- Drug interactions involving warfarin are among the most dangerous that occur commonly in clinical practice, Dr. Douglas S. Paauw said at the annual meeting of the American College of Physicians. As many as one-third of all...

Azilect, Cesamet.(Approved To avoid the risk of hypertensive crisis)(Drug overview)
June 15, 2006... Azilect (rasagiline, Teva Pharmaceuticals) An irreversible monoamine oxidase (MAO) inhibitor for treating the signs and symptoms of idiopathic Parkinson's disease as initial monotherapy and as adjunct therapy to levodopa. *...

Use of Genomics hinges on policy, discrimination laws.(Clinical report)
June 15, 2006... Washington -- Genomic science is advancing rapidly on many fronts, but without solid federal policy to prevent genetic discrimination, it will be very difficult for physicians and patients to harvest the fruits of researchers' labors, said...

ACP, AMA back 'partnership' bill.(American Medical Association)(American College of Physicians)(Brief article)
June 15, 2006... States would get federal support to experiment with covering the uninsured and pursuing disease management strategies under the bipartisan Health Partnership Act (S. 2772). The bill was introduced last month and has the support of the...

More employees decline coverage.(Brief article)
June 15, 2006... More Americans are declining their employers' offer of health insurance as premiums continue to rise, according to a study by the Robert Wood Johnson Foundation. Approximately 3 million fewer workers who were eligible for employer-sponsored...

Off-label scrips common.(Brief article)(Clinical report)
June 15, 2006... More than one in five prescriptions (21%) for commonly used medications were written for off-label indications, according to a nationally representative study. Further, 15% of those off-label prescriptions lacked any scientific evidence of...

Medicare formulary guidance.(Brief article)
June 15, 2006... If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes...

Rare disease studies.(Brief article)(Clinical report)
June 15, 2006... Officials at the National Institutes of Health have launched the first clinical studies that are part of its Rare Diseases Clinical Research Network. The network has received a total of $71 million in 5-year funding awards to study rare...

Wanted: docs to help craft pay for performance.
June 15, 2006... Chicago -- Physicians need to help design the pay-for-performance programs now being initiated by Medicare and other payers or they may not like the results, Dr. Trent Haywood said at the annual meeting of the American Association of Clinical...

Testimony: FDA leaders put politics first on Plan B: in a lawsuit, the Center for Reproductive Rights and other groups are seeking over-the-counter access for all.(Food and Drug Administration)
June 15, 2006... The Food and Drug Administration is once again under fire for its evaluation of the proposed over-the-counter use of the emergency contraceptive Plan B, with advocates for approval accusing the agency of putting politics first. Fueling...

Distrust of clinical research differs by race.(Practice Trends)(Clinical report)
June 15, 2006... Los Angeles -- Older African Americans distrust clinical research significantly more than do older whites, according to results of a mail survey presented by Dr. Raegan W. Durant at the annual meeting of the Society of General Internal...

2nd varicella dose may be advised.(News)(Disease/Disorder overview)
June 1, 2006... Available data support the move to a routine two-dose varicella vaccination policy, according to members of the Advisory Committee on Immunization Practices' varicella working group. The working group recommended a shift to a two-dose...

Alcohol use disorders deemed treatable in PC: naltrexone is effective, acamprosate isn't.(News)(Drug overview)
June 1, 2006... San Diego -- A study that is perhaps the most important conducted on alcohol dependence treatment in recent years has found that use of the opiate antagonist naltrexone reduces drinking, but use of acamprosate does not. The study, known...

Noninvasive test rules out bladder Ca in hematuria.(News)(Disease/Disorder overview)
June 1, 2006... Paris -- The noninvasive NMP22 BladderChek assay gives primary care physicians a way to screen asymptomatic patients with hematuria during office visits, Dr. H. Barton Grossman said at the annual congress of the European Association of...

Criteria modified for evaluating febrile infants.(News)(Disease/Disorder overview)
June 1, 2006... San Francisco -- A new, large study has concluded that the Rochester criteria--for determining which febrile infants are at low risk of having a serious bacterial infection--are not as sensitive as once thought. But with a modification...

FDA: infections from lens solution tied to design flaws, user issues.(News)(Brief article)
June 1, 2006... Rockville, Md. -- The Food and Drug Administration has preliminarily determined that a design flaw in Bausch & Lomb's MoistureLoc contact lens solution seems to have led to an increase in Fusarium keratitis infections, and as a result, the...

FluMist halved the flu rate of shots in tots.(News)
June 1, 2006... San Francisco -- A refrigerator-stable formulation of FluMist was significantly more effective than flu shots in a study of children aged 6-59 months. In the randomized, double-blind, phase III trial that enrolled more than 8,000...

Refrigerator-stable FluMist more convenient, as effective as frozen.(News)
June 1, 2006... San Francisco -- An experimental refrigerator-stable formulation of the live attenuated influenza vaccine marketed as FluMist was comparable to the approved frozen formulation in a phase III trial presented in a poster at the annual meeting...

Consider COX-2s for chemoprevention.(Guest Editorial)(Disease/Disorder overview)
June 1, 2006... Cyclooxygenase-2 inhibitors are appropriate as a supplemental strategy in the prevention of colorectal cancer in patients at highest risk for the disease. The current standard for preventing colon cancer, colonoscopy and polypectomy,...

HPV vaccine won't replace screening.(Letters)(Disease/Disorder overview)
June 1, 2006... The article on Gardasil highlights a very important issue about which many physicians maybe underinformed: the fact that the HPV vaccine will be an important contribution to the elimination of cervical cancer, but will not replace the need...

Migraine with aura linked to higher CHD risk.(Cardiovascular Medicine)(Disease/Disorder overview)
June 1, 2006... San Diego -- Healthy women aged 45 years and older who have migraine with aura have a significantly increased risk of coronary heart disease, myocardial infarction, coronary revascularization, and angina, results from the largest study of its...