Abstract 9181: Does a Low Ejection Fraction Predict Mortality? Insights From the ASCEND-HF Trial
Bibliographic record
Abstract
Background: Acute heart failure (AHF) is associated with significant morbidity and mortality. Limited data exist assessing the relationship between left ventricular ejection fraction (EF) and outcomes in patients with AHF. Methods: We explored the association between EF and 30-day and 180-day mortality in AHF patients enrolled in the Acute Studies of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial. EF was analyzed as a continuous variable and as 3 categories: 50%(PresEF). Results: Of the 7007 patients in the trial, EF was available in 5687 (81.2%) patients: 4474 (78.7%) had LowEF, 674 (11.9%) had IntEF, and 539 (9.5%) had PresEF. Compared to LowEF patients, those with IntEF and Pres EF were older, more likely to be female, have atrial arrhythmias, diabetes, and higher systolic blood pressure, and lower heart rate, respiratory rate and BNP. The unadjusted 30-day and 180-day mortality was similar for LowEF (3.7%, 12.3%), IntEF (3.4%, 13.1%), and PresEF (4.3%, 14.1%), respectively (p>0.05). After multivariable adjustment, the hazard ratio (HR) for 180-day mortality remained similar for the LowEF (HR 0.96, 95% CI: 0.75-1.24; p = 0.77), and IntEF (0.91, 95% CI 0.66-1.3; p = 0.58) compared to the PresEF group. By contrast, when EF was evaluated as a continuous measure, it exhibited a U-shaped relationship, i.e. the lowest risk of 30-day and 180-day death occurred at an EF of 35%. After matching for age and sex, the mortality risk attributed to EF was attenuated for patients with an EF > 35%, but the mortality risk increased exponentially if the EF was < 35%. (Fig. Conclusions: Among patients with AHF, 30-day and 180-day mortality is similar for those with IntEF or PresEF but increases exponentially for those with LowEF after accounting for key patient variables. Prior observations of a similar mortality risk for AHF patients with a higher EF need to be reevaluated.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".