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Osteoporosis: HELP
Articles by Reena Mehra
Based on 3 articles published since 2008

Between 2008 and 2019, Reena Mehra wrote the following 3 articles about Osteoporosis.
+ Citations + Abstracts
1 Article Relationship of Bisphosphonate Therapy and Atrial Fibrillation/Flutter: Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study. 2016

Thadani, Samir R / Ristow, Bryan / Blackwell, Terri / Mehra, Reena / Stone, Katie L / Marcus, Gregory M / Varosy, Paul D / Cummings, Steven R / Cawthon, Peggy M / Anonymous770857. ·Division of Cardiology, Department of Medicine, Kaiser Permanente, South San Francisco, CA; Division of Cardiology, Department of Medicine, University of California, San Francisco, CA. Electronic address: samir.r.thadani@kp.org. · Division of Cardiology, Department of Medicine, California Pacific Medical Center, San Francisco, CA. · California Pacific Medical Center Research Institute, San Francisco, CA. · Sleep Disorders Center, Neurologic Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH. · Division of Cardiology, Electrophysiology Section, Department of Medicine, University of California, San Francisco, CA. · VA Eastern Colorado Health Care System; University of Colorado, Denver; and the Colorado Outcomes Research Group, Denver, CO. ·Chest · Pubmed #26836889.

ABSTRACT: BACKGROUND: Prior studies suggested an association between bisphosphonates and atrial fibrillation/flutter (AF) in women. This relationship in men, including those with sleep-disordered breathing (SDB), remains unclear. This study evaluated the relationship between bisphosphonate use and prevalent (nocturnal) and incident (clinically relevant) AF in a population of community-dwelling older men. METHODS: A total of 2,911 male participants (mean age, 76 years) of the prospective observational Osteoporotic Fractures in Men Study sleep cohort with overnight in-home polysomnography (PSG) constituted the analytic cohort. Nocturnal AF from ECGs during PSG and incident AF events were centrally adjudicated. The association of bisphosphonate use and AF was examined using multivariable-adjusted logistic regression for prevalent AF and Cox proportional hazards regression for incident AF. RESULTS: A total of 123 (4.2%) men were current bisphosphonate users. Prevalent nocturnal AF was present in 138 participants (4.6%). After multivariable adjustment, there was a significant association between current bisphosphonate use and prevalent AF (OR, 2.33; 95% CI, 1.13-4.79). In the subset of men with moderate to severe SDB, this association was even more pronounced (OR, 3.22; 95% CI, 1.29-8.03). However, the multivariable-adjusted relationship between bisphosphonate use and incident AF did not reach statistical significance (adjusted hazard ratio, 1.53; 95% CI, 0.96-2.45). CONCLUSIONS: These results support an association between bisphosphonate use and prevalent nocturnal AF in community-dwelling older men. The data further suggest that those with moderate to severe SDB may be a particularly vulnerable group susceptible to bisphosphonate-related AF. Similar associations were not seen for bisphosphonate use and clinically relevant incident AF.

2 Article Automated detection of atrial fibrillation from the electrocardiogram channel of polysomnograms. 2016

Monahan, Ken / Song, Yanna / Loparo, Ken / Mehra, Reena / Harrell, Frank E / Redline, Susan. ·Division of Cardiovascular Medicine, Vanderbilt Medical Center, 1215 21st Avenue-5th Floor-Medical Center East, Nashville, TN, 37232, USA. ken.monahan@vanderbilt.edu. · Department of Biostatistics, Vanderbilt Medical Center, Nashville, TN, USA. · Department of Electrical Engineering and Computer Science, Case Western Reserve University, Cleveland, OH, USA. · Division of Sleep Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA. · Division of Sleep Medicine, Brigham and Women's Hospital, Boston, MA, USA. ·Sleep Breath · Pubmed #26092280.

ABSTRACT: PURPOSE: Accurate identification of atrial fibrillation episodes from polysomnograms is important for research purposes but requires manual review of a large number of long electrocardiographic tracings. As automated assessment of these tracings for atrial fibrillation may improve efficiency, this study aimed to evaluate this approach in polysomnogram-derived electrocardiographic data. METHODS: A previously described algorithm to detect atrial fibrillation from single-lead electrocardiograms was applied to polysomnograms from a large epidemiologic study of obstructive sleep apnea in older men (Osteoporotic Fractures in Men [MrOS] Sleep Study). Atrial fibrillation status during each participant's PSG was determined by independent manual review. Models to predict atrial fibrillation status from a combination of algorithm output and clinical/polysomnographic characteristics were developed, and their accuracy was evaluated using standard statistical techniques. RESULTS: Derivation and validation cohorts each consisted of 1395 individuals; 5 % of each group had atrial fibrillation. Model parameters were optimized for the derivation cohort using the Akaike information criterion. Application to the validation cohort of these optimized models revealed high sensitivity (85-90 %) and specificity (90-95 %) as well as good predictive ability, as assessed by the C statistic (>0.9) and generalized R (2) values (∼0.6). Addition of cardiovascular or polysomnogram data to the models did not improve their performance. CONCLUSIONS: In a research setting, automated detection of atrial fibrillation from polysomnogram-derived electrocardiographic signals appears feasible and agrees well with manual identification. Future studies can evaluate the utility of this technique as applied to clinical polysomnograms and ambulatory electrocardiographic monitoring.

3 Article Interpreting wrist actigraphic indices of sleep in epidemiologic studies of the elderly: the Study of Osteoporotic Fractures. 2008

Mehra, Reena / Stone, Katie L / Ancoli-Israel, Sonia / Litwack-Harrison, Stephanie / Ensrud, Kristine E / Redline, Susan / Anonymous581184. ·Department of Medicine and Center of Clinical Investigation, Case School of Medicine, Cleveland, OH 44106-6003, USA. mehrar@ameritech.net ·Sleep · Pubmed #19014077.

ABSTRACT: INTRODUCTION: Although wrist actigraphy-derived sleep indices correlate with adverse health outcomes, it is unclear whether these indices identify specific sleep disorders. METHODS: Overnight polysomnography and > or = three 24-h periods of wrist actigraphy were performed in the Study of Osteoporotic Fractures (SOF) (n = 455, age: 73-96 y). Actigraphy identified those with reduced sleep efficiency (SE, < 70%) and decreased sleep duration (< or = 5 h). Sleep disorders considered were: (1) sleep-disordered breathing (SDB): respiratory disturbance index > or =15 and (2) periodic limb movement disorder (PLMD): periodic limb movement-arousal index > or =5. Multivariable logistic regression analyses modeled each sleep disorder as the dependent variable with wrist actigraphy measures, age, race, medication use, depression, body mass index, activity, mental status, and comorbidity as independent variables. RESULTS: In multivariable models, poor SE derived from wrist actigraphy was associated with 2.4-fold higher odds of SDB (OR = 2.43, 95% CI: 1.43-4.14) and PLMD (OR = 2.36, 95% CI: 1.34-4.15). Reduced sleep duration was associated with 3.2-fold higher odds of SDB (OR = 3.18, 95% CI: 1.51-6.68), and a 3.8-fold higher odds of PLMD (OR = 3.77, 95% CI: 1.78-7.95). CONCLUSIONS: In elderly women, wrist actigraphy-ascertained reduced SE and sleep duration are associated with objective measures of SDB and PLMD. Thus, although not able to discriminate between the different sleep disorders, variations in wrist actigraphy measures collected in epidemiologic studies may identify individuals at higher risk of SDB or PLMD.