P1399Thrombus aspiration in acute coronary syndromes: Prevalence, procedural success, change in serial troponin T levels and clinical outcomes in a contemporary Swiss cohort
Bibliographic record
Abstract
Background: Randomised controlled trials have provided conflicting results regarding procedural and clinical outcomes of thrombus aspiration (TA) combined with percutaneous coronary intervention (PCI) when compared with primary PCI alone in patients with acute coronary syndromes (ACS). Purpose: To assess procedural and clinical outcomes of TA with PCI or PCI alone in the SPUM-ACS cohort (NCT01000701). Methods: ACS patients referred for coronary angiography to four Swiss university hospitals between 2009 and 2012 were enrolled in the SPUM-ACS cohort. At the discretion of the interventional cardiologist, patients underwent TA with PCI or PCI alone. Procedural success was defined as post-procedural TIMI-III flow in the infarct-related artery. Serial changes in high-sensitivity troponin T (ΔhsTnT) and adjudicated 30 days (1 year) clinical events (MACE) defined as the composite of cardiac death, recurrent myocardial infarction or clinically indicated coronary revascularisation were assessed. Results: Among 1641 patients, 777 (47.4%) had angiographic evidence of coronary thrombus. Patients were categorised into TA with PCI (n=663) or PCI alone (n=114). STEMI patients received more often TA with PCI (87.8%) than NSTEMI patients (73.5%), p<0.001. Procedural success was not different in TA with PCI compared with PCI alone (93.8% vs. 90.7%, p=0.243). ΔhsTnT was similar in STEMI patients (3.09±4.52 vs. 2.19±4.92 μg/l, p=0.086) as was clinical outcome in the entire cohort at 30 days (2.9% vs. 3.6%, p=0.76) and 1 year (7.2% vs. 5.3%, p=0.55) regardless of whether TA was used during primary PCI or not.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".