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5. Does the Effectiveness of a Medicine Copay Voucher Vary by Baseline Medication Out‐Of‐Pocket Expenses? Insights From ARTEMIS

Author

Rymer, Jennifer A, Kaltenbach, Lisa A, Peterson, Eric D, Cohen, David J, Fonarow, Gregg C, Choudhry, Niteesh K, Henry, Timothy D, Cannon, Christopher P, and Wang, Tracy Y

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Cost Effectiveness Research, Heart Disease - Coronary Heart Disease, Cardiovascular, Heart Disease, Good Health and Well Being, Humans, Health Expenditures, Medication Adherence, Myocardial Infarction, Purinergic P2Y Receptor Antagonists, Treatment Outcome, copay, myocardial infarction, persistence, voucher, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

Background Persistence to P2Y12 inhibitors after myocardial infarction (MI) remains low. Out-of-pocket cost is cited as a factor affecting medication compliance. We examined whether a copayment intervention affected 1-year persistence to P2Y12 inhibitors and clinical outcomes. Methods and Results In an analysis of ARTEMIS (Affordability and Real-World Antiplatelet Treatment Effectiveness After Myocardial Infarction Study), patients with MI discharged on a P2Y12 inhibitor were stratified by baseline out-of-pocket medication burden: low ($0-$49 per month), intermediate ($50-$149 per month), and high (≥$150 per month). The impact of the voucher intervention on 1-year P2Y12 inhibitor persistence was examined using a logistic regression model with generalized estimating equations. We assessed the rates of major adverse cardiovascular events among the groups using a Kaplan-Meier estimator. Among 7351 MI-treated patients at 282 hospitals, 54.2% patients were in the low copay group, 32.0% in the middle copay group, and 13.8% in the high copay group. Patients in higher copay groups were more likely to have a history of prior MI, heart failure, and diabetes compared with the low copay group (all P

Published
2022

6. Interleukin-6 and Cardiovascular Events in Healthy Adults: MESA

Author

Khan, Muhammad Shahzeb, Talha, Khawaja M., Maqsood, Muhammad Haisum, Rymer, Jennifer A., Borlaug, Barry A., Docherty, Kieran F., Pandey, Ambarish, Kahles, Florian, Cikes, Maja, Lam, Carolyn S.P., Ducharme, Anique, Voors, Adrian A., Hernandez, Adrian F., Lincoff, A. Michael, Petrie, Mark C., Ridker, Paul M., and Fudim, Marat

Published
2024
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8. SCAI Publications Committee Manual of Standard Operating Procedures: 2022 Update.

Author

Szerlip, Molly, Al-Azizi, Karim, Alasnag, Mirvat, Ando, Tomo, Ang, Lawrence, Bartel, Robert, Batlivala, Sarosh, Brott, Brigitta, Davidson, Laura, Dehghani, Payam, Elmariah, Sammy, Eng, Marvin, Garcia, Santiago, Giri, Jay, Goldsweig, Andrew, Gordon, Brent, Guerrero, Mayra, Herrmann, Howard, Jneid, Hani, Kar, Saibal, Lansky, Alexandra, Lata, Kusum, Madan, Mina, Madder, Ryan, Rymer, Jennifer, Senerth, Emily, Smith, Triston, Tehrani, Behnam, and Messenger, John

Subjects
evidence-based healthcare, guidelines, methodology, policy
Abstract

Evidence-based recommendations for clinical practice are intended to help health care providers and patients make decisions, minimize inappropriate practice variation, promote effective resource use, improve clinical outcomes, and direct future research. SCAI has been engaged in the creation and dissemination of clinical guidance documents since the 1990s. These documents are a cornerstone of the Societys education, advocacy, and quality improvement initiatives. The Publications Committee is charged with the oversight of SCAIs clinical documents program and has published the first iteration of this manual of standard operating procedures in 2019 to ensure consistency, methodological rigor, and transparency in the development and endorsement of the Societys documents. The manual has been updated based on feedback from the implementation of the original version to add specificity and expand the breadth of available document formats. The manual is intended for reference by the Publications Committee, document writing groups, external collaborators, SCAI representatives, peer reviewers, and anyone seeking information about the SCAI documents program.

Published
2022

12. Risk of Bleeding Among Cangrelor-Treated Patients Administered Upstream P2Y12 Inhibitor Therapy: The CAMEO Registry

Author

Rymer, Jennifer, Alhanti, Brooke, Kemp, Steven, Bhatt, Deepak L., Kochar, Ajar, Angiolillo, Dominick J., Diaz, Miguel, Garratt, Kirk N., Wimmer, Neil J., Waksman, Ron, Kirtane, Ajay J., Ang, Lawrence, Bach, Richard, Barker, Colin, Jenkins, Ronald, Basir, Mir B., Sullivan, Alex, El-Sabae, Hijrah, Brothers, Leo, Ohman, E. Magnus, Jones, W. Schuyler, Washam, Jeffrey B., and Wang, Tracy Y.

Published
2024
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19. Association of Health Status Scores With Cardiovascular and Limb Outcomes in Patients With Symptomatic Peripheral Artery Disease: Insights From the EUCLID (Examining Use of Ticagrelor in Symptomatic Peripheral Artery Disease) Trial

Author

Rymer, Jennifer A, Mulder, Hillary, Smolderen, Kim G, Hiatt, William R, Conte, Michael S, Berger, Jeffrey S, Norgren, Lars, Mahaffey, Kenneth W, Baumgartner, Iris, Fowkes, F Gerry, Katona, Brian G, Rockhold, Frank, Jones, W Schuyler, and Patel, Manesh R

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Trials and Supportive Activities, Cardiovascular, Clinical Research, Good Health and Well Being, Cardiovascular Diseases, Double-Blind Method, Female, Health Status Indicators, Humans, Lower Extremity, Male, Middle Aged, Outcome Assessment, Health Care, Peripheral Arterial Disease, Platelet Aggregation Inhibitors, Quality of Life, Surveys and Questionnaires, Symptom Assessment, Ticagrelor, Vascular Surgical Procedures, Visual Analog Scale, health status instruments, peripheral artery disease, quality of life, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

Background There are limited data on health status instruments in patients with peripheral artery disease and cardiovascular and limb events. We evaluated the relationship between health status changes and cardiovascular and limb events. Methods and Results In an analysis of the EUCLID (Examining Use of Ticagrelor in Symptomatic Peripheral Artery Disease) trial, we examined the characteristics of 13 801 patients by tertile of health status instrument scores collected in the trial (EuroQol 5-Dimensions [EQ-5D], EQ visual analog scale [VAS], and peripheral artery questionnaire). We assessed the association between the baseline health status measurements and major adverse cardiovascular events, major adverse limb events, and lower-extremity revascularization procedures during trial follow-up and the association between 12-month health status change scores and subsequent end points during follow-up. There were 13 217 (95%) patients with EQ-5D scores, 13 533 (98%) with VAS scores, and 4431 (32%) with peripheral artery questionnaire scores. Patients in the lowest baseline EQ-5D tertile (0 to

Published
2020

26. Readmissions After Acute Myocardial Infarction: How Often Do Patients Return to the Discharging Hospital?

Author

Rymer, Jennifer A, Chen, Anita Y, Thomas, Laine, Fonarow, Gregg C, Peterson, Eric D, and Wang, Tracy Y

Subjects
Humans, Myocardial Infarction, Prognosis, Length of Stay, Patient Discharge, Patient Readmission, Patient Transfer, Registries, Cause of Death, Risk Assessment, Risk Factors, Retrospective Studies, Time Factors, Aged, Aged, 80 and over, Medicare, Continuity of Patient Care, United States, Female, Male, Catchment Area, Health, length of stay, mortality, myocardial infarction, readmission, Cardiorespiratory Medicine and Haematology
Abstract

Background When patients require readmission after a recent myocardial infarction (MI), returning to the discharging (index) hospital may be associated with better outcomes as a result of greater continuity in care. However, little evidence exists to answer this frequent patient question. Methods and Results Among Medicare patients aged ≥65 years discharged home alive post-MI from 491 US hospitals in the ACTION (Acute Coronary Treatment Intervention Outcomes Network) Registry, we compared reason for readmission, duration of rehospitalization, and 30-day mortality between patients readmitted to the index versus nonindex hospital within 30 days of index MI discharge. Among 53 471 MI patients, 7715 (14%) were readmitted within 30 days, and most readmitted patients (73%) returned to the discharging hospital. Reason for readmission was not significantly associated with location of readmission. In multivariable modeling, the strongest factors associated with readmission to a nonindex hospital were distance from the discharging hospital, transfer-in during the index MI hospitalization, and frequency of nonindex hospital admissions in the year preceding to the index MI. Duration of rehospitalization did not differ significantly between patients readmitted to the index versus nonindex hospital (median, 4 versus 3 days; P=0.17). Mortality risk was also not significantly different between patients readmitted to the index versus nonindex hospital overall (7.4 versus 7.7%; adjusted odds ratio, 0.89; 95% CI, 0.73-1.10) and when stratified by reason for readmission (P for interaction=0.61). Conclusions Post-MI readmissions did not differ in reason for readmission, duration of rehospitalization, or associated mortality when compared between patients who returned to the discharging hospital and those who sought care elsewhere.

Published
2019

28. The Use of Cangrelor in Cardiogenic Shock: Insights from the CAMEO Registry.

Author

RYMER, JENNIFER, PICHAN, CAYLA, PAGE, COURTNEY, ALHANTI, BROOKE, BHATT, DEEPAK L., KOCHAR, AJAR, ANGIOLILLO, DOMINICK J., DIAZ, MIGUEL, WIMMER, NEIL J., WAKSMAN, RON, ANG, LAWRENCE, BACH, RICHARD, JENKINS, RONALD, EL-SABAE, HIJRAH, BROTHERS, LEO, OHMAN, E. MAGNUS, JONES, W. SCHUYLER, WASHAM, JEFFREY B., WANG, TRACY Y., and NARCISSE, DENNIS

Abstract

Little is known about the use of cangrelor in patients with myocardial infarction (MI) presenting with cardiogenic shock (CS). CAMEO (Cangrelor in Acute MI: Effectiveness and Outcomes) is a multicenter observational registry evaluating platelet inhibition in patients with MI. We examined the duration of cangrelor infusion and the amount of time to transition from cangrelor to an oral P2Y 12 inhibitor in patients with CS. We also assessed major adverse cardiovascular events (MACEs) and bleeding risks, stratified by dosage duration, time to transition and oral P2Y 12 inhibitor potency. Among 2352 cangrelor-treated patients with MI, 249 patients were in CS. Among the patients with CS, 16 (6.4%) received the "bridge" infusion dose, 202 (81.1%) the PCI cangrelor infusion dose, and 30 (12.0%) had a combination of both infusion doses. Patients with CS had a median age of 66 years; 32% were women; 21% were Black patients; 35% had diabetes; 19% received thrombectomy; and 59% received mechanical circulatory support (MCS) (35% intra-aortic balloon pump, 27% Impella). The median duration of infusion was 3.9 (2–21.5 hours) in patients with CS and was 2 (1.6–3.1 hours) for all cangrelor-treated patients. The median duration of transition from cangrelor to oral P2Y 12 inhibitor administration was 0.1 (-0.5–21.0 hours) for patients with CS. In multivariable modeling, chronic lung disease and the use of MCS and was associated with longer cangrelor infusions (defined as > 3.9 hours). Among cangrelor-treated patients with CS, 24.1% of these patients had a bleeding event, and 41.8% had a MACE event. After adjustment, a longer cangrelor infusion duration was associated with increased risk of bleeding (P < 0.05). The median duration of cangrelor infusion was longer for patients presenting with CS. Use of MCS was associated with longer cangrelor infusion durations in patients with CS. Further work is needed to understand the pharmacodynamics of antiplatelet agents in patients with CS. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Myocardial Revascularization in Heart Failure: A State-of-the-Art Review.

Author

TANNU, MANASI, NELSON, ADAM J., RYMER, JENNIFER A., and JONES, W. SCHUYLER

Abstract

• Identifying which patients with coronary artery disease (CAD) and acute heart failure (HF) or left ventricular systolic dysfunction will benefit from revascularization is challenging owing to population heterogeneity. • We propose a treatment algorithm that categorizes patients with CAD and HF/left ventricular systolic dysfunction into 2 frameworks: those exhibiting CAD-predominant symptoms (acute myocardial infarction, refractory angina, or positive stress test) vs those with HF-predominant symptoms (dyspnea, orthopnea, peripheral edema without angina or positive stress test). • Randomized controlled trials and observational data indicate that revascularization benefits patients with CAD-predominant symptoms, but does not confer symptomatic or mortality benefit in those with HF-predominant symptoms. Patients with heart failure (HF) and underlying coronary artery disease (CAD) have a substantially higher risk of mortality compared with those with HF from other causes. However, identifying individuals with HF for whom revascularization is likely to improve prognosis is a complex clinical decision. Revascularization is likely beneficial for patients with CAD-predominant symptoms, such as those with acute myocardial infarction or stable ischemic heart disease with refractory angina. However, for patients with HF-predominant symptoms, characterized by dyspnea without acute myocardial infarction or refractory angina, the benefits of revascularization are less clear. This state-of-the-art review summarizes the outcomes, clinical trials, and therapeutic approaches for patients with both CAD and HF, and proposes a therapeutic algorithm to guide the diagnosis and comprehensive workup of these complex patients. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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30. Influence of Obesity on Coronary Artery Disease and Clinical Outcomes in the ADVANCE Registry

Author

Lowenstern, Angela, Ng, Nicholas, Takagi, Hidenobu, Rymer, Jennifer A., Koweek, Lynne M., Douglas, Pamela S., Duran, Jessica M., Rabbat, Mark, Pontone, Gianluca, Fairbairn, Timothy, Chinnaiyan, Kavitha, Berman, Daniel S., De Bruyne, Bernard, Bax, Jeroen J., Akasaka, Takashi, Amano, Tetsuya, Nieman, Koen, Rogers, Campbell, Kitabata, Hironori, Sand, Niels P.R., Kawasaki, Tomohiro, Mullen, Sarah, Matsuo, Hitoshi, Norgaard, Bjarne L., Patel, Manesh R., Leipsic, Jonathan, and Daubert, Melissa A.

Published
2023
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32. Case Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States

Author

Rymer, Jennifer A., primary, Narcisse, Dennis I., additional, Chen, Angel, additional, Wojdyla, Daniel, additional, Ashley, Sarah, additional, Damluji, Abdulla A., additional, Shah, Binita, additional, Nanna, Michael G., additional, Swaminathan, Rajesh, additional, Gutierrez, J. Antonio, additional, Uzendu, Anezi, additional, Nelson, Adam J., additional, Bethel, Garrett, additional, Kearney, Katherine, additional, Jones, W. Schuyler, additional, Rao, Sunil V., additional, and Doll, Jacob A., additional

Published
2024
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34. Dual Antiplatelet and Anticoagulation Regimens for Women Undergoing Percutaneous Coronary Intervention.

Author

Kansal, Aman, Swamy, Pooja, and Rymer, Jennifer A.

Abstract

Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention is necessary for preventing stent thrombosis and ensuring long-term cardiovascular protection. It is important to be thoughtful in balancing thrombotic and bleeding risk when deciding therapy regimen and duration. Revascularization randomized trials have studied many specific, at-risk populations; however, women remain underrepresented. Although there is evidence to support shortened DAPT duration in women, especially those at higher bleeding risk or on chronic oral anticoagulation, we need trials specifically enrolling and focusing on women. [ABSTRACT FROM AUTHOR]

Published
2025
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36. Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial

Author

Pokorney, Sean D., Chertow, Glenn M., Al-Khalidi, Hussein R., Gallup, Dianne, Dignacco, Pat, Mussina, Kurt, Bansal, Nisha, Gadegbeku, Crystal A., Garcia, David A., Garonzik, Samira, Lopes, Renato D., Mahaffey, Kenneth W., Matsuda, Kelly, Middleton, John P., Rymer, Jennifer A., Sands, George H., Thadhani, Ravi, Thomas, Kevin L., Washam, Jeffrey B., Winkelmayer, Wolfgang C., and Granger, Christopher B.

Published
2022
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37. Abstract 13803: Contribution of Clinical Trial Event Data by Data Source: Insights From the ADAPTABLE Trial

Author

Rymer, Jennifer A, Mulder, Hillary, Wruck, Lisa M, Munoz, Daniel, Kripalani, Sunil, Effron, Mark B, gupta, Kamal, Handberg, Eileen M, Jain, Sandeep, Girotra, Saket, Whittle, Jeffrey, Hess, Rachel, Benziger, Catherine, Knowlton, Kirk U, Curtis, Lesley, Roe, Matthew T, Hammill, Bradley G, Rothman, Russell, Harrington, Josephine, Hernandez, Adrian F, and Jones, William

Published
2022
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39. Abstract 12458: Limb and Cardiovascular Events at 6 Months Among CLTI Patients Receiving Routine Care at BEST-CLI Sites: An Interim Report From the BEST-Registry

Author

Weissler, Hope, Patel, Manesh R, Shah, Nishant, Patterson, Abigail, Rymer, Jennifer A, MENARD, Matthew, Drew, Laura A, Mark, Daniel B, Mena-Hurtado, Carlos, Brooke, Benjamin, Molnar, Robert, Zayed, Mohamed, Shah, Samir, Kashyap, Vikram S, Beckman, Joshua, Laskowski, Igor, Rosenfield, Kenneth, FARBER, Alik, and Vemulapalli, Sreekanth

Published
2022
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41. Contribution of Clinical Trial Event Data by Data Source: A Prespecified Analysis of the ADAPTABLE Randomized Clinical Trial.

Author

Rymer, Jennifer A., Mulder, Hillary, Wruck, Lisa M., Muñoz, Daniel, Kripalani, Sunil, Effron, Mark B., Gupta, Kamal, Handberg, Eileen, Jain, Sandeep, Girotra, Saket, Whittle, Jeffrey, Hess, Rachel, Benziger, Catherine P., Knowlton, Kirk U., Curtis, Lesley H., Roe, Matthew T., Hammill, Bradley G., Rothman, Russell L., Harrington, Robert, and Hernandez, Adrian

Published
2024
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46. A new classification of cardio-oncology syndromes

Author

de Boer, Rudolf A., Aboumsallem, Joseph Pierre, Bracun, Valentina, Leedy, Douglas, Cheng, Richard, Patel, Sahishnu, Rayan, David, Zaharova, Svetlana, Rymer, Jennifer, Kwan, Jennifer M., Levenson, Joshua, Ronco, Claudio, Thavendiranathan, Paaladinesh, and Brown, Sherry-Ann

Published
2021
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