P6363Real world experience with Reducer implantation for refractory angina treatment
Bibliographic record
Abstract
Background: Refractory angina is defined as chronic chest pain, due to severe coronary artery disease (CAD) despite optimal medical therapy and with no option for interventional or surgical revascularization. Coronary sinus (CS) Reducer (Neovasc Inc., Richmond B.C., Canada) implantation emerged as a novel therapeutic treatment to improve quality of life and to relieve symptoms in these patients. To date, only a single randomized clinical trial and three observational studies demonstrating safety and efficacy are available. Purpose: Aim of this study is to assess clinical efficacy of the Reducer device in a real-world setting. Methods: This is a multicentre, observational retrospective registry involving Italy, Israel, The Netherlands, and Belgium. Patients' baseline clinical characteristics, Canadian Cardiovascular Society (CCS) angina severity class, and Seattle Angina Questionnaire (SAQ) scores at baseline and follow-up were recorded. Results: Between March 2010 and December 2017, a total of 207 patients underwent Reducer implantation procedure. In two patients the procedure was aborted due to unsuitable CS anatomy. No cases of periprocedural serious adverse events were reported. Patients were 67.6±10.5 years old, 140 (68.3%) were male, with a high prevalence of CAD risk factors, 34 (20.1%) had chronic kidney disease. A total of 113 (55.1%) had a previous myocardial infarction, 152 (74.1%) a previous CABG, 172 (83.9%) a previous PCI. All suffered from severe refractory angina (CCS class 3.15±0.58) with low scores at the baseline SAQ. Mean number of anti-ischemic drugs prescribed was 2.3±0.9.
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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 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".