Abstract 1694: Reduced Incidence of Contrast Induced Nephropathy after Percutaneous Coronary Intervention with Routine Use of Visipaque in Unselected Patients
Bibliographic record
Abstract
Objective: An observational study to determine if the routine use of Visipague contrast solution was associated with a decreased incidence of contrast-induced nephropathy (CIN) in patients following PCI at a large, tertiary cardiac centre. Methods: The Toronto General Hospital Interventional Cardiology Program maintains a prospective registry of all PCI procedures12951 consecutive patients undergoing PCI from a prospective data registry were assigned to either Period 1 (2000 – 03, various contrast agents were utilized) or Period 2 (2003– 06, only Visipaque was used). The contrast agent was changed systematically to the iso-osmolar agent, Visipaque. CIN was defined as an increase in plasma creatinine of >25% within 24 hours following PCI. Using propensity scores, 2502 consecutive patients undergoing PCI in Period 1, were randomly matched to 2502 patients in Period 2. Multivariate logistic regression analysis was used to identify the independent predictors of CIN. Results: The two well matched cohorts showed no significant differences in major pre-procedure clinical variables. Visipaque was associated with a lower rate of CIN after PCI (Period 1 = 14%, Period 2 = 7%, p<0.001). The multivariate independent predictors of CIN were: Visipaque (OR 0.437, p<0.001), contrast media volume per 10 ml (OR 1.015; p<0.0001), pre-procedure creatinine per 10mmol/L (OR 1.013; p=0.003), ACS (OR 2.861; p <0.001), PCI following thrombolysis (OR 1.952; p=0.022), peripheral vascular disease (OR 1.375; p=0.023), and age per decade over 40 (OR 1.143; p=0.001) Conclusions: After adjusting for significant predictors of CIN, a strategy of routine use of an iso-osmolar contrast agent (Visipaque) appeared to be associated with a lower risk of developing CIN after PCI, especially in higher risk patients. Contrast volume, ACS and age were the most powerful predictors of development of contrast nephropathy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".