Guideline on antiplatelet and anticoagulation management in cardiac surgery
Bibliographic record
Abstract
We congratulate Dunning and colleagues for their guideline on antiplatelet and anticoagulation management in cardiac surgery [1]. However, we disagree with the authors’ statement regarding a lack of studies demonstrating safety of perioperative tranexamic acid (TA) administration and venous graft patency. Our research group conducted a double-blind prospective randomized controlled trial exploring the very issue of intra-operative administration of TA and early saphenous vein graft (SVG) patency in patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass (CPB) [2]. A total of 312 patients were randomized to receive either TA or placebo. The primary objective of this study was to determine the equivalency of SVG patency rates between the treatment and placebo groups. In 237 patients saphenous vein graft patency was assessed with magnetic resonance imaging during the first month postoperatively. Our results showed insignificant variation in graft patency rates between the two groups. Consequently, TA could be advocated for routine use in patients undergoing coronary revascularization procedures with CPB to minimize postoperative bleeding and reduce perioperative blood product transfusion rates.
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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 | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.013 | 0.012 |
| Insufficient payload (model declined to judge) | 0.004 | 0.004 |
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".