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P1879Empagliflozin reduces mortality and hospitalisation for heart failure irrespective of cardiovascular risk score at baseline

2018· article· en· W2904003910 on OpenAlexaff
David Fitchett, Silvio E. Inzucchi, Christopher P. Cannon, Darren K. McGuire, OE Johansen, Steven Sambevski, Uwe Hehnke, Jyothis T. George, Bernard Zinman

Bibliographic record

VenueEuropean Heart Journal · 2018
Typearticle
Languageen
FieldMedicine
TopicDiabetes Treatment and Management
Canadian institutionsMount Sinai HospitalUniversity of TorontoLunenfeld-Tanenbaum Research InstituteSt. Michael's Hospital
Fundersnot available
KeywordsMedicineHeart failureBaseline (sea)Internal medicineCardiologyFramingham Risk ScoreDisease

Abstract

fetched live from OpenAlex

Background: In the EMPA-REG OUTCOME trial in patients with type 2 diabetes and established cardiovascular (CV) disease, empagliflozin added to standard of care reduced CV death vs placebo by 38% (HR 0.62 [95% CI 0.49, 0.77]), all-cause death by 32% (HR 0.68 [95% CI 0.57, 0.82]) and hospitalisation for heart failure (HHF) by 35% (HR 0.65 [95% CI 0.50, 0.85]). We investigated whether residual CV risk at baseline influenced the effect of empagliflozin on these outcomes. Methods: We investigated CV death, all-cause death, HHF and the composite of HHF or CV death with empagliflozin vs placebo in subgroups by degree of CV risk at baseline based on the 10-point TIMI Risk Score for Secondary Prevention (TRS 2°P). P-values for treatment-by-subgroup interaction were obtained from tests of homogeneity of treatment group differences among subgroups with no adjustment for multiple testing. Results: Based on the TRS 2°P risk score, of 7020 patients who received study drug in the EMPA-REG OUTCOME trial, 12%, 40%, 30% and 18% were at low, intermediate, high and highest residual CV risk, respectively, at baseline. In the placebo group, from low to highest predicted risk, the proportion of patients with CV death increased from 2.2% to 11.2% and the proportion of patients with HHF increased from 1.1% to 10.0%. Effects of empagliflozin on CV death, all-cause death, HHF and HHF or CV death were consistent across subgroups by baseline CV risk score (Figure).

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.008

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.046
GPT teacher head0.299
Teacher spread0.253 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2018
Admission routes1
Has abstractyes

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