Abstract 14705: Quality of Life Improvement in Coronary Artery Disease by Adenosine Magnetic Resonance Driven Management in Comparison to Conventional Approach
Bibliographic record
Abstract
Introduction: Cardiac magnetic resonance imaging (CMR) currently plays a marginal role in the daily practice work-up of coronary artery disease (CAD). However, it provides high accuracy regarding inducible myocardial ischemia and necrosis. A CMR driven management of CAD patients may thus contribute to quality of life improvement. Hypothesis: This prospective and randomized trial aimed to prove improvement of quality of life assessed by the Seattle Angina Questionnaire (SAQ) using a CMR driven therapy approach in comparison to a conventional approach. Methods: Patients presenting with typical angina, positive prior stress test other than CMR, and intermediate CAD probability were included into the study. All patients had an indication for coronary x-ray angiography (CXA) and received optimal medical therapy according to current guidelines. Patients were randomized in a CMR or CXA group. All CMR subjects underwent adenosine (140μg/kg/min for 3 minutes) CMR at 3 Tesla (0.075 mmol Gd-DOTA/kg). Patients in the CMR group only underwent CXA, if myocardial ischemia was detected. All patients in the CXA arm underwent CXA procedure. PCI was performed in case of significant stenosis (>75% in LAD, CX, or RCA or >50% in LM). Results: CXA and CMR group did not differ significantly in the primary endpoint (p=0.16). Baseline SAQ was not different for all SAQ subscales. At one year SAQ subscales 1 (0.8 ±0.04 vs. 0,71 ± 0.06, p=0.007), 4 (0.82 ± 0.04 vs. 0.77 ± 0.04, p=0.046), and 5 (0.74 ± 0.05 vs. 0.65 ± 0.06, p=0.015) were significantly better in the CMR group. After two and three years of follow-up SAQ subscales did not differ between CXA and CMR group. Conclusions: Event free survival in CMR driven CAD management does not differ to conventional management. During the first year angina stability, treatment satisfaction, and disease perception is better in the CMR group. However, after one year, there is no significant difference. Hence, CMR driven management is safe and improves quality of life compared to conventional CAD management.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 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".