Abstract 19277: Neither Comorbidities nor Socioeconomic Differences Explain the Association Between Higher Altitude of Residence and Better Coronary Artery Disease Survival
Bibliographic record
Abstract
Background: Previous studies have linked higher altitude of residence with lower mortality from coronary artery disease, but were limited by incomplete ascertainment of co-morbidities, including hypertension, dyslipidemia, diabetes, and smoking, as well as lack of adjustment for socioeconomic variables such as education status and household income. Methods: We tested whether comorbidities and socioeconomic variables alter the association between altitude of residence and both results of coronary angiography and survival of those with coronary artery disease using the APPROACH database, a prospective cohort of all subjects undergoing coronary angiography in the Province of Alberta. Co-morbidities and mortality are ascertained by periodic linkage with Alberta Health, the provincial repository of administrative health data. The population was stratified by altitude of residence into quartiles based on residence postal codes, and logistic regression was used to calculate odds ratios for high risk or left main disease at coronary angiography, with the lowest quartile the reference. A Cox proportional hazard model was used to calculate hazard ratios for mortality, with the lowest quartile the reference. Results: A total of 105,093 consecutive subjects referred for coronary angiography between 1995 and 2010 were included, spanning elevations between 210 meters to 2,164 meters. After adjustment for comorbidities and socioeconomic variables, the odds ratio for the highest quartile having high risk or left main coronary disease at angiography was 0.86 (0.82-0.90). Survival analysis was restricted to 78,349 subjects with at least one >50% coronary lesion. The hazard ratio for mortality for the highest quartile was 0.88 (0.84-0.93) adjusting for all variables except coronary anatomy, and 0.95 (0.90-0.99) after adjusting for all variables. Conclusion: Higher altitude of residence was associated with lower odds of having high risk or left main coronary artery disease at coronary angiography and better survival, even after adjustment for comorbidities and socioeconomic variables.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 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".