The prevalence of cardiac risk factors in women 45 years of age or younger undergoing angiography for evaluation of undiagnosed chest pain.
Bibliographic record
Abstract
BACKGROUND: Relatively little is known about the prevalence of cardiac risk factors, the use of noninvasive testing and the medical management of younger women (younger than 45 years of age) undergoing evaluation for chest pain. OBJECTIVES: To determine the rate of angiographically critical coronary artery disease (CAD) in women under the age of 45 years who were sent for first-time evaluation of chest pain requiring cardiac catheterization, and to determine the prevalence of cardiac risk factors, the role of noninvasive testing and the quality of medical management in these patients. PATIENTS AND METHODS: A retrospective chart review was performed on all female patients aged 45 years or younger from February 1997 to December 2000 (n=187) without prior known CAD referred for diagnostic cardiac catheterization. Chart information was studied, including catheterization results, cardiac risk factors, noninvasive testing done before catheterization (within six months) and medications at discharge. RESULTS: Angiographically critical CAD was found in 55 of 187 patients (29%), of whom 52% had single-vessel disease. One hundred twenty-one patients (65%) had completely normal coronary arteries. The most prominent cardiac risk factor for all study patients was a family history of premature CAD (67%), followed by smoking (55%) and dyslipidemia (55%). When compared with people without CAD, women with CAD had a higher prevalence of dyslipidemia (72% versus 47%, P=0.002), diabetes (29% versus 9%, P<0.001) and smoking (67% versus 50%, P=0.03). Noninvasive testing including exercise stress testing (calculated sensitivity of 44% and a specificity of 73%), and stress sestamibi scintigraphy (sensitivity of 67%, specificity of 30%) were both found to be poor predictors of those with CAD. Of all patients diagnosed as having critical CAD (n=55), 40% were discharged on an angiotensin-converting enzyme inhibitor, 73% on acetylsalicylic acid and 69% on a beta-blocker. CONCLUSIONS: The present study implies that younger women with CAD may have a higher prevalence of dyslipidemia, diabetes and smoking. The high percentage of women with minimally diseased or normal coronary arteries emphasizes the importance of confirmatory testing and poor use of noninvasive testing. The medical management of young women diagnosed with CAD is seemingly suboptimal, which may have important implications in later years of life.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".