Abstract 283: Health Status Outcomes in Acute Myocardial Infarction Patients Following Rehospitalization for Unplanned Revascularization or Unstable Angina
Bibliographic record
Abstract
Background: Rehospitalizations for unplanned coronary revascularization and unstable angina (UA) among patients after myocardial infarction (MI) are common. The association of these events with health status is unknown. Methods: Patients with MI were enrolled between 2005 and 2008 in the TRIUMPH registry-a prospective, 24 center U.S. study. Follow-up was attempted on all survivors at 1, 6 and 12 months after index MI admission. Data on all reported re-hospitalizations were adjudicated. Staged revascularizations and elective coronary artery bypass grafts performed within the first month after the index MI were excluded. Health status was assessed using the Seattle Angina Questionnaire (SAQ) and Euroqol-5D Visual Analog Scale (EQ-5D VAS). One-year health status was compared between those who did and did not experience a rehospitalization due to a coronary revascularization or UA using hierarchical, repeated measures analyses in 2 propensity-matched cohorts created for each of these events. Results: A total of 3,283 MI patients were analyzed; mean age was 59 years, 33% were female and 70% were Caucasian. In the year following the MI there were 144 (4.4%) re-hospitalizations for unplanned coronary revascularization and 140 (4.3%) for UA. Baseline health status was comparable between patients with and without re-hospitalizations. In contrast, SAQ summary scores at 1 year post-MI were lower in patients with re-hospitalizations for unplanned revascularization (-10.1; 95% CI -12.4, -7.9) and UA readmissions (mean difference -6.9; 95% CI -9.1, -4.7) vs. those without. Similarly, EQ-5D VAS scores were lower among patients with readmissions for unplanned revascularization and UA readmissions (Table). Individual domains of the SAQ score indicated higher angina frequency, worse quality of life, and more physical limitations over the year following the index MI among patients re-hospitalized for UA and revascularization. Conclusions: Rehospitalizations within the first year following a MI for unplanned coronary revascularization and UA are associated with more angina and worse health status. Whether more aggressive treatment of patients’ health status can prevent these events, or if preventing these events can improve patients’ health status, requires further study.
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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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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".