Publications by authors named "Rymer J"
Salter, J, Forsdyke, D, Dawson, Z, Rymer, J, Walsh, L, and Mundy, P. Reliability and sensitivity of using isometric strength and sprint speed measures in adolescent female athletes. J Strength Cond Res XX(X): 000-000, 2024-The aim of this study was to establish the reliability and sensitivity of isometric mid-thigh pull (IMTP) and sprint speed (5 m, 40 m, and maximal sprint speed) in adolescent women, before exploring the stability of this across maturation to provide maturity-specific benchmarks.
View Article and Find Full Text PDFBackground: Randomized controlled trials (RCTs) of complete revascularization (CR) versus culprit-only revascularization (COR) in patients with ST-elevation myocardial infarction (STEMI) have shifted the recommendation for CR from class III to class I in the AHA/ACC/SCAI guidelines, but it remains unclear if the benefit of CR over COR extends to older adults, who have greater bleeding risk, comorbidity burden, and complexity of lesions. We performed a meta-analysis to place the results of the previous RCTs in the context of the recently published FIRE trial and the subgroup analysis of the COMPLETE trial in adults ≥75 years old.
Methods: We searched the literature from inception to October 21, 2023.
Article Synopsis
- The study examines the use and outcomes of P2Y inhibitor pretreatment in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in the U.S. from 2013 to 2023.
- P2Y inhibitor pretreatment rates decreased significantly from 24.8% to 12.4% over the study period, with only 15.9% in a recent cohort showing such treatment.
- There was notable variability in pretreatment rates among different operators and institutions, with no significant difference in in-hospital mortality between those who received pretreatment and those who did not.
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.
View Article and Find Full Text PDFBackground: Older adults with non-ST-segment-elevation acute coronary syndrome are less likely to undergo an invasive strategy compared with younger patients. Randomized controlled trials traditionally exclude older adults because of their high burden of geriatric conditions.
Methods And Results: We searched for randomized controlled trials comparing invasive versus medical management or a selective invasive (conservative) strategy for older patients (age≥75 years) with non-ST-segment-elevation acute coronary syndrome.
Article Synopsis
- Patients with heart failure (HF) and coronary artery disease (CAD) are at a higher risk of dying than those with HF from other causes.
- Revascularization can help patients with CAD-related symptoms, like a recent heart attack or severe chest pain that isn't relieved by medication.
- For patients whose main issues are related to heart failure, like shortness of breath without a heart attack, the advantages of revascularization are not as clear; the review proposes a guide for diagnosis and treatment.
Article Synopsis
- The study investigates the use of cangrelor in patients with myocardial infarction (MI) who also have cardiogenic shock (CS), focusing on the infusion duration and transition to oral medications.
- A total of 249 patients with CS were analyzed, with significant observations on demographics, infusion times, and the occurrence of major adverse cardiovascular events (MACEs) and bleeding risks.
- The findings showed that patients with CS had longer cangrelor infusions compared to others, and that the use of mechanical circulatory support (MCS) was linked to longer infusion times and an increased risk of bleeding.
Article Synopsis
- - Uterine leiomyomas, affecting up to 80% of women, cause issues like abnormal bleeding, pelvic pain, and infertility, but their growth mechanisms are not well understood.
- - Research showed that uterine leiomyomas had lower levels of CD73 expression and adenosine compared to healthy myometrium, suggesting a link to tumor growth regulation.
- - Experiments indicated that adding adenosine or certain receptor agonists inhibited the growth of leiomyoma cells by promoting cell death and reducing key protein expressions, proposing new treatment approaches for these tumors.
Use of Calcium Modification During Percutaneous Coronary Intervention After Introduction of Coronary Intravascular Lithotripsy.
J Soc Cardiovasc Angiogr Interv
February 2024
Article Synopsis
- Calcified coronary lesions pose difficulties for percutaneous coronary interventions (PCIs), and coronary intravascular lithotripsy (IVL), approved in February 2021, offers a new approach but its adoption in the U.S. is not well understood.
- Among 2.7 million PCIs analyzed, 11.4% utilized calcium modification, with IVL usage increasing from 0% in late 2020 to 7.8% by late 2022, while coronary atherectomy slightly decreased.
- Significant variation in IVL use was observed across hospitals, with the treating hospital being the main factor influencing both calcium modification and IVL adoption in 2022.
SCAI Expert Consensus Statement on the Management of Calcified Coronary Lesions.
J Soc Cardiovasc Angiogr Interv
February 2024
The prevalence of calcification in obstructive coronary artery disease is on the rise. Percutaneous coronary intervention of these calcified lesions is associated with increased short-term and long-term risks. To optimize percutaneous coronary intervention results, there is an expanding array of treatment modalities geared toward calcium modification prior to stent implantation.
View Article and Find Full Text PDFRisk of Bleeding Among Cangrelor-Treated Patients Administered Upstream P2Y Inhibitor Therapy: The CAMEO Registry.
J Soc Cardiovasc Angiogr Interv
February 2024
Article Synopsis
- The study investigated the bleeding risk associated with cangrelor in patients with myocardial infarction (MI) who had previously taken an oral P2Y inhibitor before angiography.
- The CAMEO registry analyzed 1802 patients treated with cangrelor, finding that 21.4% had also received an oral P2Y inhibitor within the previous 24 hours.
- Results showed no significant difference in bleeding rates between patients with and without prior oral P2Y inhibitor exposure, indicating that cangrelor use does not substantially increase bleeding risk in either group.
Article Synopsis
- Elevated levels of interleukin-6 (IL-6) are linked to worse health outcomes, including higher mortality rates and heart failure, in patients regardless of existing cardiovascular disease (CVD).
- This study analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA) to explore the relationship between IL-6 levels and various health outcomes across different racial and ethnic groups, finding that those in the highest IL-6 category faced significantly greater risks.
- The findings indicate that high IL-6 levels are consistently associated with increased all-cause and cardiovascular mortality, as well as heart failure, impacting individuals across diverse racial and ethnic backgrounds.
Article Synopsis
- The study investigates how different data sources (like electronic health records, insurance claims, and participant reports) contribute to analyzing clinical outcomes in a pragmatic randomized clinical trial (RCT) involving patients with atherosclerotic cardiovascular disease.
- Conducted from April 2016 to June 2019, the ADAPTABLE study looked at the effects of daily aspirin doses on certain health events, while comparing participant data availability to enhance understanding of outcome rates.
- The findings revealed a predominance of participant-reported and EHR data, with only a small percentage relying solely on claims data, indicating the need for further study on the varying contributions of each data source to overall clinical results.
In 2020, the NIH and FDA issued guidance documents that laid the foundation for human subject research during an unprecedented pandemic. To bridge these general considerations to actual applications in cardiovascular interventional device trials, the PAndemic Impact on INTErventional device ReSearch (PAIINTERS) Working Group was formed in early 2021 under the Predictable And Sustainable Implementation Of National CardioVascular Registries (PASSION CV Registries). The PAIINTER's Part I report, published by Rymer et al.
View Article and Find Full Text PDFObjective: The aim of the project was to reduce the risk of patients using the estrogen only part of their hormone replacement therapy (HRT) inadvertently in Banstead PCN. Although understanding about the risk of unopposed estrogen is well understood by prescribers, there are numerous flash points where this exposure can occur which was highlighted by several cases encountered during a study period of 3 months.
Study Design: Cases encountered revealed numerous reasons for this exposure which were split into three areas: Prescribing factors, dispensing checks and patient understanding.
Article Synopsis
- This study investigates the differences in procedural characteristics, patient outcomes, and case volumes between early-career and non-early-career interventional cardiologists in the U.S. from April 2018 to June 2022.
- Data from various medical databases revealed that early-career operators treated more critically ill patients, such as those with ST-segment myocardial infarction, despite having similar annual case volumes compared to their more experienced counterparts.
- The findings indicate that early-career cardiologists face higher predicted risks for mortality and bleeding in their patients, with statistical adjustments confirming a significant association between early-career status and increased risks.
Article Synopsis
- This study focuses on the risk of late ventricular tachycardia (VT) and ventricular fibrillation (VF) in patients who have undergone primary percutaneous coronary intervention (PCI) for STEMI, noting that while mortality risk is low, incidents of VT and VF may occur post-procedure.
- Researchers analyzed data from 174,126 patients treated with primary PCI between 2015 and 2018, discovering that 8.9% experienced VT or VF, with 2.4% specifically having late VT or VF occurring after the procedure.
- The study identified demographic data showing a median age of 63 for patients with late VT or VF, and the findings highlight