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1,211 results on '"Desai, Nihar R."'

1. Design and rationale of FINE-REAL: A prospective study of finerenone in clinical practice

Author

Desai, Nihar R, Navaneethan, Sankar D, Nicholas, Susanne B, Pantalone, Kevin M, Wanner, Christoph, Hamacher, Stefanie, Gay, Alain, and Wheeler, David C

Subjects
Diabetes, Kidney Disease, Patient Safety, Clinical Research, Management of diseases and conditions, 7.1 Individual care needs, Renal and urogenital, Metabolic and endocrine, Good Health and Well Being, Adult, Humans, Diabetes Mellitus, Type 2, Prospective Studies, Mineralocorticoid Receptor Antagonists, Double-Blind Method, Diabetic Nephropathies, Renal Insufficiency, Chronic, Finerenone, Prescribing patterns, Healthcare resource utilization, Chronic kidney disease, Type 2 diabetes, Clinical Sciences, Endocrinology & Metabolism
Abstract

AimsContemporary patterns of care of patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D) and the adoption of finerenone are not known. The FINE-REAL study (NCT05348733) is a prospective observational study in patients with CKD and T2D to provide insights into the use of the nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone in clinical practice.MethodsFINE-REAL is an international, prospective, multicenter, single-arm study enrolling approximately 5500 adults with CKD and T2D in an estimated 200 sites across 22 countries. The study is anticipated to be ongoing until 2027.ResultsThe primary objective is to describe treatment patterns in patients with CKD and T2D treated with finerenone in routine clinical practice. Secondary objectives include assessment of safety with finerenone. Other endpoints include characterization of healthcare resource utilization and occurrence of newly diagnosed diabetic retinopathy or its progression from baseline in patients with existing disease. A biobank is being organized for future explorative analyses with inclusion of participants from the United States.ConclusionsFINE-REAL is the first prospective observational study with a nonsteroidal MRA in a population with CKD and T2D and is expected to provide meaningful insights into the treatment of CKD associated with T2D. FINE-REAL will inform decision-making with respect to initiation of finerenone in patients with CKD and T2D.

Published
2023

11. Artificial Intelligence, Computational Simulations, and Extended Reality in Cardiovascular Interventions

Author

Samant, Saurabhi, Bakhos, Jules Joel, Wu, Wei, Zhao, Shijia, Kassab, Ghassan S., Khan, Behram, Panagopoulos, Anastasios, Makadia, Janaki, Oguz, Usama M., Banga, Akshat, Fayaz, Muhammad, Glass, William, Chiastra, Claudio, Burzotta, Francesco, LaDisa, John F., Jr., Iaizzo, Paul, Murasato, Yoshinobu, Dubini, Gabriele, Migliavacca, Francesco, Mickley, Timothy, Bicek, Andrew, Fontana, Jason, West, Nick E.J., Mortier, Peter, Boyers, Pamela J., Gold, Jeffrey P., Anderson, Daniel R., Tcheng, James E., Windle, John R., Samady, Habib, Jaffer, Farouc A., Desai, Nihar R., Lansky, Alexandra, Mena-Hurtado, Carlos, Abbott, Dawn, Brilakis, Emmanouil S., Lassen, Jens Flensted, Louvard, Yves, Stankovic, Goran, Serruys, Patrick W., Velazquez, Eric, Elias, Pierre, Bhatt, Deepak L., Dangas, George, and Chatzizisis, Yiannis S.

Published
2023
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27. Why has positive inotropy failed in chronic heart failure? Lessons from prior inotrope trials

Author

Ahmad, Tariq, Miller, P Elliott, McCullough, Megan, Desai, Nihar R, Riello, Ralph, Psotka, Mitchell, Böhm, Michael, Allen, Larry A, Teerlink, John R, Rosano, Giuseppe MC, and Lindenfeld, Joann

Subjects
Heart Disease, Clinical Trials and Supportive Activities, Cardiovascular, Clinical Research, Cardiotonic Agents, Chronic Disease, Clinical Trials as Topic, Exercise Tolerance, Heart Failure, Hemodynamics, Humans, Mortality, Myocardial Contraction, Quality of Life, Stroke Volume, Treatment Failure, Chronic heart failure, Inotropes, Clinical trials, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
Abstract

Current pharmacological therapies for heart failure with reduced ejection fraction are largely either repurposed anti-hypertensives that blunt overactivation of the neurohormonal system or diuretics that decrease congestion. However, they do not address the symptoms of heart failure that result from reductions in cardiac output and reserve. Over the last few decades, numerous attempts have been made to develop and test positive cardiac inotropes that improve cardiac haemodynamics. However, definitive clinical trials have failed to show a survival benefit. As a result, no positive inotrope is currently approved for long-term use in heart failure. The focus of this state-of-the-art review is to revisit prior clinical trials and to understand the causes for their findings. Using the learnings from those experiences, we propose a framework for future trials of such agents that maximizes their potential for success. This includes enriching the trials with patients who are most likely to derive benefit, using biomarkers and imaging in trial design and execution, evaluating efficacy based on a wider range of intermediate phenotypes, and collecting detailed data on functional status and quality of life. With a rapidly growing population of patients with advanced heart failure, the epidemiologic insignificance of heart transplantation as a therapeutic intervention, and both the cost and morbidity associated with ventricular assist devices, there is an enormous potential for positive inotropic therapies to impact the outcomes that matter most to patients.

Published
2019

35. Achievement and quality measure attainment in patients hospitalized with atrial fibrillation: Results from The Get With The Guidelines – Atrial Fibrillation (GWTG-AFIB) registry

Author

Ullal, Aditya J., Holmes, DaJuanicia N., Lytle, Barbara L., Matsouaka, Roland A., Sheng, Shubin, Desai, Nihar R., Curtis, Anne B., Fang, Margaret C., McCabe, Pamela J., Fonarow, Gregg C., Russo, Andrea M., Lewis, William R., Heidenreich, Paul A., Piccini, Jonathan P., Turakhia, Mintu P., and Perino, Alexander C.

Published
2022
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37. Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF)

Author

Ghazi, Lama, Desai, Nihar R., Simonov, Michael, Yamamoto, Yu, O'Connor, Kyle D., Riello, Ralph J., Huang, Joanna, Olufade, Temitope, McDermott, James, Inzucchi, Silvio E., Velazquez, Eric J., Wilson, F. Perry, and Ahmad, Tariq

Published
2022
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38. Epidemiology and risk factors for hyperkalaemia in heart failure.

Author

Grobbee, Diederick E., Filippatos, Gerasimos, Desai, Nihar R., Coats, Andrew J. S., Pinto, Fausto, Rosano, Giuseppe M. C., Cleland, John G. F., Kammerer, Jennifer, and de Arellano, Antonio Ramirez

Subjects
MAJOR adverse cardiovascular events, DISEASE risk factors, HEART failure patients, CHRONIC kidney failure, CLINICAL epidemiology, HEART failure
Abstract

Patients with heart failure (HF), particularly those with impaired renal function receiving renin–angiotensin–aldosterone system inhibitors (RAASis), are at risk of hyperkalaemia; when hyperkalaemia is severe, this can have serious clinical consequences. The incidence, prevalence, and risk factors for hyperkalaemia reported in randomized trials of RAASis may not reflect clinical practice due to exclusion of patients with elevated serum potassium (sK+) or severe renal impairment: information on patients managed in routine clinical care is important to understanding the actual burden of hyperkalaemia. This paper reviews the available clinical epidemiology data on hyperkalaemia in HF and considers areas requiring further research. Observational studies published since 2017 that focused on hyperkalaemia, included patients with HF, and had ≥1000 participants were considered. Hyperkalaemia occurrence in HF varied widely from 7% to 39% depending on the setting, HF severity, follow‐up length, and concomitant medications. Rates were lowest in patients with newly diagnosed HF and highest in patients with greater disease severity; comorbidities, such as chronic kidney disease and diabetes, and RAASi use, reflected commonly identified risk factors for hyperkalaemia in patients with HF. Hyperkalaemia was most often mild; however, from the limited data available, persistence of mild hyperkalaemia was associated with an increased risk of mortality and major adverse cardiovascular events. There were also limited data available on the progression of hyperkalaemia. Recurrence was common, occurring in one‐quarter to two‐fifths of hyperkalaemia cases. Despite HF guidelines recommending close monitoring of sK+, 55–93% of patients did not receive appropriate testing before or after initiation of RAASi or in follow‐up to moderate/severe hyperkalaemia detection. Many of the observational studies were retrospective and from a single country. There is a need for international, prospective, longitudinal, observational studies, such as the CARE‐HK in HF study (NCT04864795), to understand hyperkalaemia's prevalence, incidence, and severity; to identify and characterize cases that persist, progress, and recur; to highlight the importance of sK+ monitoring when using RAASi; and to assess the impact of newer HF therapies and potassium binders in clinical practice. Data from both clinical trials and observational studies with adjustments for confounding variables will be needed to assess the contribution of hyperkalaemia to clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling.

Author

Dharmarajan, Kumar, McNamara, Robert L, Wang, Yongfei, Masoudi, Frederick A, Ross, Joseph S, Spatz, Erica E, Desai, Nihar R, de Lemos, James A, Fonarow, Gregg C, Heidenreich, Paul A, Bhatt, Deepak L, Bernheim, Susannah M, Slattery, Lara E, Khan, Yosef M, and Curtis, Jeptha P

Subjects
Heart Disease, Cardiovascular, Aging, Clinical Research, Heart Disease - Coronary Heart Disease, Good Health and Well Being, Adolescent, Adult, Age Factors, Aged, Hospital Mortality, Hospitals, Humans, Middle Aged, Myocardial Infarction, Outcome Assessment, Health Care, Retrospective Studies, United States, Young Adult, Clinical Sciences, Public Health and Health Services
Abstract

BackgroundPublicly reported hospital risk-standardized mortality rates (RSMRs) for acute myocardial infarction (AMI) are calculated for Medicare beneficiaries. Outcomes for older patients with AMI may not reflect general outcomes.ObjectiveTo examine the relationship between hospital 30-day RSMRs for older patients (aged ≥65 years) and those for younger patients (aged 18 to 64 years) and all patients (aged ≥18 years) with AMI.DesignRetrospective cohort study.Setting986 hospitals in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines.ParticipantsAdults hospitalized for AMI from 1 October 2010 to 30 September 2014.MeasurementsHospital 30-day RSMRs were calculated for older, younger, and all patients using an electronic health record measure of AMI mortality endorsed by the National Quality Forum. Hospitals were ranked by their 30-day RSMRs for these 3 age groups, and agreement in rankings was plotted. The correlation in hospital AMI achievement scores for each age group was also calculated using the Hospital Value-Based Purchasing (HVBP) Program method computed with the electronic health record measure.Results267 763 and 276 031 AMI hospitalizations among older and younger patients, respectively, were identified. Median hospital 30-day RSMRs were 9.4%, 3.0%, and 6.2% for older, younger, and all patients, respectively. Most top- and bottom-performing hospitals for older patients were neither top nor bottom performers for younger patients. In contrast, most top and bottom performers for older patients were also top and bottom performers for all patients. Similarly, HVBP achievement scores for older patients correlated weakly with those for younger patients (R = 0.30) and strongly with those for all patients (R = 0.92).LimitationMinority of U.S. hospitals.ConclusionHospital mortality rankings for older patients with AMI inconsistently reflect rankings for younger patients. Incorporation of younger patients into assessment of hospital outcomes would permit further examination of the presence and effect of age-related quality differences.Primary funding sourceAmerican College of Cardiology.

Published
2017

40. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial

Author

CHOUAIRI, FOUAD, FUERY, MICHAEL A., MULLAN, CLANCY W., CARABALLO, CESAR, SEN, SOUNOK, MAULION, CHRISTOPHER, WILKINSON, SAMUEL T., SURTI, TORAL, MCCULLOUGH, MEGAN, MILLER, P. ELLIOTT, PACOR, JUSTIN, LEIFER, ERIC S., FELKER, G. MICHAEL, VELAZQUEZ, ERIC J., FIUZAT, MONA, O'CONNOR, CHRISTOPHER M., JANUZZI, JAMES L, DESAI, NIHAR R., and AHMAD, TARIQ

Published
2021
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46. Intercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure

Author

Fuery, Michael A., Chouairi, Fouad, Januzzi, James L., Moe, Gordon W., Caraballo, Cesar, McCullough, Megan, Miller, P. Elliott, Reinhardt, Samuel W., Clark, Katherine, Oseran, Andrew, Milner, Aidan, Pacor, Justin, Kahn, Peter A., Singh, Avinainder, Ravindra, Neal, Guha, Avirup, Vadlamani, Lina, Kulkarni, Neeti S., Fiuzat, Mona, Felker, G. Michael, O’Connor, Christopher M., Ahmad, Tariq, Ezekowitz, Justin, and Desai, Nihar R.

Published
2021
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