Abstract 14976: Influence of Myocardial Viability on the Outcome of Patients with Coronary Artery Disease and Left Ventricular Dysfunction Undergoing Coronary Bypass Surgery With and Without Surgical Ventricular Reconstruction: Results of the Surgical Treatment for Ischemic Heart Failure (STICH) Trial
Bibliographic record
Abstract
Background: In the STICH study, adding surgical ventricular reconstruction (SVR) to coronary bypass surgery (CABG) was not associated with a reduction in the rate of death or hospitalization for cardiac causes compared to results of CABG alone. We tested the hypothesis that the absence of viable myocardium identifies patients with coronary artery disease (CAD) and left ventricular (LV) dysfunction who have the greatest benefit with CABG + SVR compared to CABG alone. Methods: Myocardial viability was assessed by single photon computed tomography (SPECT) in 267 of the 1,000 patients randomized to CABG or CABG + SVR in STICH. All had severe regional LV dysfunction involving the anteroapical wall. A 17-segment LV model was used and segments were determined to be viable based on pre-specified criteria. A patient was deemed as having viable myocardium if 11 or more LV segments were viable. Results: Among the 267 patients, 226 (85%) were men, mean age 61±9 years. Mean LV ejection fraction was 27±5%, and 89% of patients had a previous myocardial infarction. Myocardial viability was identified in 191 (72%) of the study patients; the remaining 76 were classified as nonviable. Patients with and without viability were similar in age (61±10 vs. 62±9) and ejection fraction (27±6 vs. 28±5%). Patients without viability had larger LV end-diastolic and systolic volume indices than those with viability (143±53 vs. 115±41 and 112±48 vs. 85±38 ml/m2, respectively; p Conclusion: In patients with CAD and severe regional LV dysfunction, assessment of myocardial viability does not identify patients who will benefit in terms of survival or cardiac hospitalization from adding SVR to CABG.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".