P2895Evaluation of the effect of oral anticoagulants on all-cause mortality within 3 months of the diagnosis of atrial fibrillation: results from the GARFIELD-AF prospective registry
Bibliographic record
Abstract
Purpose: Using data from the largest multinational prospective registry in atrial fibrillation (the Global Anticoagulant Registry in the FIELD–Atrial Fibrillation, GARFIELD-AF), we examined whether treatment effects of oral anticoagulation (OACs) vs no OAC and, non-vitamin K antagonist oral anticoagulants (NOACs) vs VKAs on all-cause mortality are manifest within 3 months of diagnosis of AF in patients with a CHA2DS2-VASc score ≥2 (including gender). Methods: Patients were enrolled consecutively into GARFIELD-AF and followed prospectively. The analyses were conducted in patients enrolled between Apr-2013 and Sep-2016, during which time NOACs became available in many countries. Within each comparison, overlap probability weighting was used to evaluate the adjusted associations between drug use (at baseline) and outcomes within 3 months. Weights were applied to Cox proportional hazards models to estimate the effects for OAC vs no OAC and NOAC vs VKA use for each endpoint, respectively. Results: The study population comprised 20,457 anticoagulated patients (10,330 [NOACs]; 10,127 [VKAs]) and 8,019 patients without OAC (of the latter, 60% received anti-platelets). 442 patients died within 3 months of diagnosis of AF; the Kaplan-Meier survival rate at 3 months was 98%. The causes of death were: cardiovascular (in 41% of cases), non-cardiovascular (36%) and unknown (22%). Congestive heart failure (16%), cancer (8%) and respiratory failure (6%) were the most common known causes of death followed by: myocardial infarction (5%), ischaemic stroke (5%), sudden death (5%), infection (5%) and sepsis (5%). After weighting, standardised differences showed an accurate balance between the 29 baseline variables and drug use. Weighted hazard ratios (HR) for all-cause mortality were: 0.57 (95% CI, 0.46–0.71); P<0.001 for the comparison of OAC vs non OAC; and 0.69 (95% CI, 0.52–0.92); P=0.010 for NOACS vs VKAs (figure). Stroke/systemic embolism (117 events, overall) and major bleeding (99 events) were not significantly different for the treatment comparisons.
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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 | 0.005 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".