INDICATIONS FOR MYOCARDIAL REVASCULARIZATION – ARE THEY USING EQUALLY FOR CHOOSING OF INVASIVE STRATEGY IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE?
Bibliographic record
Abstract
The purpose was to reveal the value of separate indications for myocardial revascularization as well as their combinations for choosing invasive or conservative strategy of treatment in patients with stable coronary artery disease (CAD) during 2012–2015 years.Materials and methods. The retrospective data of 1196 patients (mean age: 52.5 ± 8.4 years; 77,0 % men) were analyzed, from the register of patients with stable CAD (2012–2015 years), who had separate indications for myocardial revascularization and their combination. Patients were divided into 2 groups: with an invasive (n = 481 patients without considering the revascularization method) and conservative (n = 715 patients) treatment strategy. Indications for revascularization are taken from the recommendations of the European Society of Cardiology 2014.Results. The most common indication for myocardial revascularization was the presence of any coronary stenosis in combination with the limiting angina in the context of optimal medication (88.1 % in the invasive treatment group, 94.3 % in the conservative therapy group, p 0.001). In half of the patients in both groups this indication was found in isolation, in the rest – in combination with other indications for surgical treatment. Among the combinations of indications, significant differences between the groups showed the following. Stenosis of the LM 50 % + proximal stenosis LAD 50 %+ limiting angina pectoris occurred in 1.5 % of the patients in the invasive treatment group versus 3.8 % with the conservative strategy (p = 0.020). Proximal stenosis LAD 50 % was more common among operated patients (10.6 % vs 4.6 % in the conservative treatment group, p 0.001). Two- and three-vessel lesions + ejection fraction LV 40 % + limiting angina pectoris also occurred more frequently in the invasive treatment group (2.5 % vs 0.6 % in the conservative strategy group, p = 0.006).The remaining indications for myocardial revascularization and their combination were equally common in both groups.Conclusion. The presence of isolated proximal LAD stenosis or multivessel lesion with reduced left ventricular function accompanied with limiting angina was associated with the choice of invasive strategy in patients with stable CAD (data for 2012–2015 years). The lesion LM combined with proximal stenosis LAD and limiting angina pectoris and requiring coronary artery bypass grafting was associated with the choice of a conservative strategy. Almost half of the patients (48.6 %) had revascularization to improve the quality of life.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".