Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Coronary Artery Disease: HELP
Articles by Mandeep R. Mehra
Based on 3 articles published since 2009
(Why 3 articles?)
||||

Between 2009 and 2019, Mandeep R. Mehra wrote the following 3 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Article Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. 2018

Zannad, Faiez / Anker, Stefan D / Byra, William M / Cleland, John G F / Fu, Min / Gheorghiade, Mihai / Lam, Carolyn S P / Mehra, Mandeep R / Neaton, James D / Nessel, Christopher C / Spiro, Theodore E / van Veldhuisen, Dirk J / Greenberg, Barry / Anonymous1911086. ·From the Université de Lorraine, INSERM Unité 1116 and Clinical Investigation Center 1433, French Clinical Research Infrastructure Network, Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists, Centre Hospitalier Régional et Universitaire de Nancy, Vandoeuvre lès Nancy, France (F.Z.) · the Department of Cardiology and Berlin-Brandenburg Center for Regenerative Therapies, German Center for Cardiovascular Research partner site Berlin, Charité Universitätsmedizin Berlin, Berlin (S.D.A.) · Janssen Research and Development, Raritan (W.M.B., C.C.N.), and Bayer U.S., Research and Development, Pharmaceuticals, Thrombosis and Hematology Therapeutic Area, Whippany (T.E.S.) - both in New Jersey · Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow, Glasgow, and the National Heart and Lung Institute, Imperial College London, London - both in the United Kingdom (J.G.F.C.) · Janssen Research and Development, Spring House, PA (M.F.) · Northwestern University, Chicago (M.G.) · National Heart Centre Singapore and Duke-National University of Singapore, Singapore (C.S.P.L.) · the Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (C.S.P.L., D.J.V.) · Brigham and Women's Hospital and Harvard Medical School, Boston (M.R.M.) · the Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis (J.D.N.) · and the Department of Medicine, Cardiology Division, University of California, San Diego, San Diego (B.G.). ·N Engl J Med · Pubmed #30146935.

ABSTRACT: BACKGROUND: Heart failure is associated with activation of thrombin-related pathways, which predicts a poor prognosis. We hypothesized that treatment with rivaroxaban, a factor Xa inhibitor, could reduce thrombin generation and improve outcomes for patients with worsening chronic heart failure and underlying coronary artery disease. METHODS: In this double-blind, randomized trial, 5022 patients who had chronic heart failure, a left ventricular ejection fraction of 40% or less, coronary artery disease, and elevated plasma concentrations of natriuretic peptides and who did not have atrial fibrillation were randomly assigned to receive rivaroxaban at a dose of 2.5 mg twice daily or placebo in addition to standard care after treatment for an episode of worsening heart failure. The primary efficacy outcome was the composite of death from any cause, myocardial infarction, or stroke. The principal safety outcome was fatal bleeding or bleeding into a critical space with a potential for causing permanent disability. RESULTS: Over a median follow-up period of 21.1 months, the primary end point occurred in 626 (25.0%) of 2507 patients assigned to rivaroxaban and in 658 (26.2%) of 2515 patients assigned to placebo (hazard ratio, 0.94; 95% confidence interval [CI], 0.84 to 1.05; P=0.27). No significant difference in all-cause mortality was noted between the rivaroxaban group and the placebo group (21.8% and 22.1%, respectively; hazard ratio, 0.98; 95% CI, 0.87 to 1.10). The principal safety outcome occurred in 18 patients who took rivaroxaban and in 23 who took placebo (hazard ratio, 0.80; 95% CI, 0.43 to 1.49; P=0.48). CONCLUSIONS: Rivaroxaban at a dose of 2.5 mg twice daily was not associated with a significantly lower rate of death, myocardial infarction, or stroke than placebo among patients with worsening chronic heart failure, reduced left ventricular ejection fraction, coronary artery disease, and no atrial fibrillation. (Funded by Janssen Research and Development; COMMANDER HF ClinicalTrials.gov number, NCT01877915 .).

2 Article Early aspirin use and the development of cardiac allograft vasculopathy. 2017

Kim, Miae / Bergmark, Brian A / Zelniker, Thomas A / Mehra, Mandeep R / Stewart, Garrick C / Page, Deborah S / Woodcome, Erica L / Smallwood, Jennifer A / Gabardi, Steven / Givertz, Michael M. ·Center for Advanced Heart Disease, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Renal Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Center for Advanced Heart Disease, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: mgivertz@bwh.harvard.edu. ·J Heart Lung Transplant · Pubmed #28781013.

ABSTRACT: BACKGROUND: Cardiac allograft vasculopathy (CAV) remains a leading cause of morbidity and mortality after orthotopic heart transplantation (OHT). Little is known about the influence of aspirin on clinical expression of CAV. METHODS: We followed 120 patients with OHT at a single center for a median of 7 years and categorized them by the presence or absence of early aspirin therapy post-transplant (aspirin treatment ≥6 months in the first year). The association between aspirin use and time to the primary end-point of angiographic moderate or severe CAV (International Society for Heart and Lung Transplantation grade ≥2) was investigated. Propensity scores for aspirin treatment were estimated using boosting models and applied by inverse probability of treatment weighting (IPTW). RESULTS: Despite a preponderance of risk factors for CAV among patients receiving aspirin (male sex, ischemic heart disease as the etiology of heart failure, and smoking), aspirin therapy was associated with a lower rate of moderate or severe CAV at 5 years. Event-free survival was 95.9% for patients exposed to aspirin compared with 79.6% for patients without aspirin exposure (log-rank p = 0.005). IPTW-weighted Cox regression revealed a powerful inverse association between aspirin use and moderate to severe CAV (adjusted hazard ratio 0.13; 95% confidence interval 0.03-0.59), which was directionally consistent for CAV of any severity (adjusted hazard ratio 0.50; 95% confidence interval 0.23-1.08). CONCLUSIONS: This propensity score-based comparative observational analysis suggests that early aspirin exposure may be associated with a reduced risk of development of moderate to severe CAV. These findings warrant prospective validation in controlled investigations.

3 Article Rationale and design of a randomized, double-blind, event-driven, multicentre study comparing the efficacy and safety of oral rivaroxaban with placebo for reducing the risk of death, myocardial infarction or stroke in subjects with heart failure and significant coronary artery disease following an exacerbation of heart failure: the COMMANDER HF trial. 2015

Zannad, Faiez / Greenberg, Barry / Cleland, John G F / Gheorghiade, Mihai / van Veldhuisen, Dirk J / Mehra, Mandeep R / Anker, Stefan D / Byra, William M / Fu, Min / Mills, Roger M. ·Inserm Centre d'Investigation Clinique CIC 1433, UMR 1116, CHU de Nancy, Institut Lorrain du Coeur et des Vaisseaux, Université de Lorraine, Nancy, France. · Department of Medicine, Cardiology Division, University of California, San Diego, La Jolla, CA, USA. · National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London, England. · Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. · Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. · Brigham and Women's Hospital Heart and Vascular Center, and Harvard Medical School, Boston, MA, USA. · Division of Innovative Clinical Trials, Department of Cardiology, University Medical Centre Göttingen (UMG), Göttingen, Germany. · Janssen Research & Development, LLC, 920 US 202, Raritan, NJ, USA. ·Eur J Heart Fail · Pubmed #25919061.

ABSTRACT: AIMS: Thrombin is a critical element of crosstalk between pathways contributing to worsening of established heart failure (HF). The aim of this study is to explore the efficacy and safety of rivaroxaban 2.5 mg bid compared with placebo (with standard care) after an exacerbation of HF in patients with reduced ejection fraction (HF-rEF) and documented coronary artery disease. METHODS: This is an international prospective, multicentre, randomized, double-blind, placebo-controlled, event-driven study of approximately 5000 patients for a targeted 984 events. Patients must have a recent symptomatic exacerbation of HF, increased plasma concentrations of natriuretic peptides (B-type natriuretic peptide ≥200 pg/mL or N-terminal pro-B-type natriuretic peptide ≥800 pg/mL), with left ventricular ejection fraction ≤40% and coronary artery disease. Patients requiring anticoagulation for atrial fibrillation or other conditions will be excluded. After an index event (overnight hospitalization, emergency department or observation unit admission, or unscheduled outpatient parenteral treatment for worsening HF), patients will be randomized 1:1 to rivaroxaban or placebo (with standard of care). The primary efficacy outcome event is a composite of all-cause mortality, myocardial infarction or stroke. The principal safety outcome events are the composite of fatal bleeding or bleeding into a critical space with potential permanent disability, bleeding events requiring hospitalization and major bleeding events according to International Society on Thrombosis and Haemostasis bleeding criteria. CONCLUSION: COMMANDER HF is the first prospective study of a target-specific oral antithrombotic agent in HF. It will provide important information regarding rivaroxaban use following an HF event in an HF-rEF patient population with coronary artery disease.