P533Prognostic relevance of subclinical coronary and carotid atherosclerosis in asymptomatic at-risk adult population
Bibliographic record
Abstract
Background: There is a lack of data demonstrating imaging-based atherosclerosis prognostic value in an asymptomatic population. Purpose: The aim of the study was to evaluate the incremental prognostic benefit of carotid artery disease and subclinical coronary artery disease (CAD) features in addition to conventional clinical evaluation in asymptomatic population. Methods: Over a six-year period, 10-year-Framingham Risk Score (FRS) together with carotid ultrasound (CUS) and coronary computed tomography angiography (CCTA) were evaluated for the prediction of coronary heart disease (CHD) events. Results: We enrolled 517 consecutive asymptomatic patients (63% male, 64±10 years of age). Median CACS was 34 [0–100]. Over a median follow-up of 4.4 [3.4–5.1] years there were a total of 53 CHD events (10%). Patients experiencing CHD had higher CACS, higher incidence of carotid disease, presence of CAD≥50%, and remodeled plaque as compared to patients without CHD events. At multivariable analyses, presence of CAD≥50% (HR=5.14, 95% CI: 2.1–12.4) and percentage of segment with remodeled plaque (HR=1.04, 95% CI: 1.03–1.06) independently predict CHD risk (P<0.001). The models adding CAD≥50% or percentage of segments with remodeled plaque resulted in higher discrimination and reclassification ability compared to a model based on 10-year FRS, carotid disease and CACS. Specifically, the C-statistic improved up to 0.75 with the addition of CAD and 0.84 when adding percentage of segments with remodeled plaque, while net reclassification improvement index were 0.86 and 0.92 respectively.
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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 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".