5994Use of drug eluting stents compared to bare metal stents in ST segment elevation myocardial infarction is associated with reduced mortality and cardiovascular outcomes: results from the TOTAL trial
Bibliographic record
Abstract
Background: The safety and efficacy of drug eluting stents (DES) in the setting of ST elevation myocardial infarction (STEMI) remains controversial. Purpose: To compare the outcomes of STEMI patients receiving DES to those receiving a bare metal stent (BMS) during primary PCI. Methods: In the TOTAL trial, patients presenting with STEMI were randomized to routine thrombectomy versus PCI alone. Propensity matching was used to assess relative safety and efficacy according to type of stent used. Results: DES were used in 4333 patients and BMS in 5090 patients. The composite primary outcome of cardiovascular death, recurrent MI, cardiogenic shock or class IV heart failure within one year was 5.8% in the DES group, compared with 8.7% in the BMS group (hazard ratio 0.66; 95% CI 0.57 to 0.77, p<0.0001.) The incidence of all cause death (2.7% vs 5%, p<0.0001), cardiovascular death (2.5% vs 4.1%, p<0.0001), recurrent MI (1.6% vs 3.1%, p<0.0001), target vessel revascularization (TVR) (3.1% vs 5.7%, p<0.0001) and stent thrombosis (1.4% vs 2.5%, p=0.0003) were lower in the DES group compared to the BMS group. Following propensity matching, 3124 patients were included in each group. The hazard ratio remained significant, favouring DES for the primary endpoint (Figure a, p<0.0001), as well as for cardiovascular death (Figure b, p<0.0001), all cause death (p<0.0001), MI (p<0.0001), TVR (p<0.0001), and stent thrombosis (p=0.003).
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 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 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".