P2723A real world comparison of a pharmacoinvasive versus primary PCI strategy in ST-elevation myocardial infarction: ST-segment recovery and clinical outcome
Bibliographic record
Abstract
Background: Recent clinical trial data supports a pharmacoinvasive (PI) strategy as a useful alternative to primary percutaneous coronary intervention (PPCI) in early treated patients with ST-elevation myocardial infarction (STEMI). Purpose: We evaluated whether this assertion was supported in a “real world” established pre-hospital STEMI network using electrocardiogram (ECG) assessment of reperfusion along with clinical outcome. Methods: Between August 2006 to March 2011 (n=2079) and October 2013 to June 2016 (n=1208) we studied 3287 consecutive STEMI patients receiving reperfusion within 12 hours of symptom onset using the Alberta Vital Heart Response Program. The ECGs were analyzed within an established core laboratory blinded to clinical outcomes; ST-segment deviation resolution ≥50% was defined as the measure of successful reperfusion (∼30 minutes post PCI ECG for PI and PPCI). The primary composite endpoint was 1-year all-cause death, congestive heart failure (CHF), cardiogenic shock and recurrent myocardial infarction (MI). Logistic regression models were used to examine the multi-variable adjusted association between reperfusion strategy and outcome.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 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".