Abstract P027: Individualized Protein Based Cardiovascular Risk Stratification: Impact On Patient And Physician Decision Making In Patients With Real World Cardiovascular Disease
Notice bibliographique
Résumé
There is a growing population of patients with established cardiovascular disease and residual cardiovascular risk. Identification of patients who would benefit most from more advanced risk reduction strategies would be ideal. Hypothesis: Identification of secondary risk of MACE may change both physician recommendations and patient choices regarding goal directed therapy (GDT). Methods: Retrospective review of 244 patients with established CAD with traditional assessment of secondary cardiovascular risk and SomaScan proteomic risk assessment followed over 3 years. Patients were evaluated for GDT and standard measurements were made at baseline. SomaScan protein risk score was obtained. Patients received advice regarding risk and offered GDT with established secondary prevention goals. Willingness to change, physician recommendations to change therapy and therapy changes were recorded. Patients were followed over three years. Results: 244 patients were included in the cohort; 186 males (76%), 58 females (24%). Mean age of 66, range 32-84. Diagnosis of coronary artery disease was made based on imaging in 121 patients (49%) and clinical events including CABG, MI, PCI in 123 patients (51%). Secondary cardiovascular risk of MACE by SomaScan was assessed in 5 predefined risk classes. There were 70 patients in class I (0-9.9%), 116 patients in Class II (10-19.9%), 41 patients in Class III (20-29.9%), 12 patients in Class IV (30-59%) and I patient in Class V (60-100%). GDT was already present in 143 patients including statin therapy, ACE inhibition and daily aspirin. In the cohort, 101 patients were sub-optimally treated. After reviewing results of SomaScan results, 20 patients initiated GDT, 52 patients intensified GDT. This included addition of second lipid lowering agent, initiation of PCSK-9 inhibitors, ACE-inhibition and intense lifestyle management. Overall, 30% of the overall cohort had a change in therapy: 39 patients were advised to alter therapy and did not, 17 patients would not begin goal directed therapy, 22 patients would not intensify management to meet accepted goals. Two deaths occurred during the study period. There were 14 episodes of MACE. Conclusions: In this population of patients with established cardiovascular disease only 58% were on guideline-based therapy. Use of SomaScan results in conjunction with standard assessment allowed an additional 30% of patients to change therapy with initiation of GDT and intensification of GDT to meet current guidelines.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».