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Abstract P7: The Impact of Cardiovascular Hospitalization on Mortality and Quality of Life Among 14,261 Atrial Fibrillation Patients in the ACTIVE Study

2011· article· en· W2473350394 on OpenAlexaff
Robby Nieuwlaat, Jennifer Ng, Basil S. Lewis, Andrzej Budaj, Stuart J. Connolly

Bibliographic record

VenueCirculation Cardiovascular Quality and Outcomes · 2011
Typearticle
Languageen
FieldMedicine
TopicAtrial Fibrillation Management and Outcomes
Canadian institutionsPopulation Health Research Institute
Fundersnot available
KeywordsMedicineAtrial fibrillationInternal medicineRelative riskSinus rhythmHeart failureQuality of life (healthcare)Coronary artery diseaseProportional hazards modelCardiologyConfidence interval

Abstract

fetched live from OpenAlex

Background Cardiovascular (CV) hospitalization has been used as primary outcome in atrial fibrillation (AF) research, but remains controversial. Our aim was to provide detailed information on characteristics and impact of CV hospitalization among 14,261 patients in the ACTIVE clinical trial. Methods Patient characteristics, mortality and time to first non-fatal CV hospitalization were measured in the ACTIVE controlled clinical trial setting. Multivariable proportional hazards regression analysis was used to determine factors associated with CV hospitalization, and to assess the independent association of CV hospitalization with all-cause mortality and quality of life using the EuroQoL scale. Results During a median follow-up of 3 years and 11 months, 10,584 CV hospitalizations were observed, of which 9,859 were non-fatal and 725 fatal. Non-fatal CV hospitalization had occurred in 50% of patients after 4 years follow-up and was more likely to occur in patients with at baseline heart failure (relative risk (RR) = 1.32; p<0.0001), coronary artery disease (RR = 1.43; p<0.0001), an antiarrhythmic drug (RR = 1.19; p<0.0001), sinus rhythm (RR = 1.42; p<0.0001) and with a history of fainting (RR = 1.23; p<0.0001), while less likely in working patients (RR = 0.84; p<0.0001). All-cause mortality in patients with at least 1 CV hospitalization was 6.60 per 100 patient years versus 4.97 per 100 patient years in patients without CV hospitalization. In time-dependent analysis, patients with CV hospitalization had an increased risk for mortality (RR = 3.13; p<0.0001), which remained significant when adjusting for baseline risk factors (RR = 3.00; p<0.0001). Heart failure hospitalization had the strongest association with mortality (RR = 5.92; p<0.0001), while hospitalization for AF was not associated (RR = 1.08; p=0.3058). The decrease in the EuroQoL quality of life score during the study was larger in surviving patients with CV hospitalization (−0.03 ± 22) compared with remaining survivors (−0.01 ± 21; p<0.0001). Conclusions Half of ACTIVE study patients had at least one CV hospitalization during 4 years, which was associated with increased mortality and a reduced quality of life in surviving patients. Hospitalization for AF alone was not associated with mortality.

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How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.005
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.012
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0050.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.002
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.174
GPT teacher head0.375
Teacher spread0.201 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations0
Published2011
Admission routes1
Has abstractyes

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