Declining In‐Hospital Mortality and Increasing Heart Failure Incidence in Elderly Patients With First Myocardial Infarction
Bibliographic record
Abstract
Abstract. Objectives. The purpose of this study was to examine the long‐term incidence of heart failure (HF) in elderly patients with myocardial infarction (MI). Background. In‐hospital HF is common after MI and is associated with poor short‐term prognosis. Limited data exist concerning the long‐term incidence or prognosis of HF after MI, particularly in the era of coronary revascularization. Methods. A population‐based cohort of 7733 patients 65 years and older hospitalized for a first MI (International Classification of Diseases, 9th Revision Clinical Modification code 410.x) and without a prior history of HF was established between 1994 and 2000 in Alberta, Canada, and followed up for 5 years. Results. During the index MI hospitalization, 2831 (37%) MI patients were diagnosed with new HF and 1024 (13%) died. Among hospital survivors who did not have HF during their index hospitalization (n=4291), an additional 3040 patients (71%) developed HF by 5 years, 64% of which occurred in the first year. In total, 5871 (76%) elderly patients who survived their first MI developed HF over 5 years. Among those who survived the index hospitalization, the 5‐year mortality rate was 39.1% for those with HF during the index MI hospitalization compared with 26.7% among those without HF (P<.0001) during the index MI hospitalization. Over the study period, the 5‐year mortality rate after MI decreased by 28%, whereas the 5‐year rate of HF increased by 25%. Conclusions. In this large cohort of elderly patients without a history of HF, HF developed in three‐quarters in the 5 years after their first MI; this proportion increased over time as peri‐MI mortality rates declined. New‐onset HF significantly increases the mortality risk among these patients.—Ezekowitz JA, Kaul P, Bakal JA, et al. Declining in‐hospital mortality and increasing heart failure incidence in elderly patients with first myocardial infarction.J Am Coll Cardiol. 2009;53(1):21–23.
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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 | 0.001 | 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".