P1494The prognostic significance of atrial fibrillation in patients with ST-elevation myocardial infarction: a sub-study of the randomized TOTAL trial
Bibliographic record
Abstract
Background/Introduction: Atrial fibrillation (AF) often accompanies ST-elevation myocardial infarction (STEMI). The long-term prognostic value of AF in STEMI is somewhat controversial. Purpose: The aim of the present study was to determine the long-term prognostic significance of AF in the pre-PCI ECG in STEMI patients undergoing primary PCI. Methods: We analyzed 1-year follow up data of 8,830 patients from the randomized Trial of Routine Aspiration Thrombectomy with PCI versus PCI Alone in Patients with STEMI (TOTAL) trial. Patients with AF were compared with patients with sinus rhythm. The primary outcome was a composite of cardiovascular death, recurrent myocardial infarction, cardiogenic shock or new or worsening New York Heart Association (NYHA) class IV heart failure. Results: Of the patients, 437 (4.9%) had AF on admission. Patients with AF were older and had more often a medical history of stroke, hypertension and myocardial infarction. The rate of primary outcome and cardiovascular death was higher in the AF group than in the sinus rhythm group (17.4% vs. 7.4%; HR 2.51; 95% Cl 1.97–3.19, p<0.001 and 9.8% vs. 3.3%; HR 3.12; 95% Cl 2.26–4.31, p<0.001, respectively). Patients with AF also had a higher rate of all-cause mortality (11.4% vs. 3.9%; HR 3.06; 95% CI 2.27–4.12, p<0.001), major bleeding (3.2% vs. 1.8%; HR 1.81; 95% CI 1.05–3.13, p=0.033) and stroke (2.7% vs. 0.9%; HR 3.21; 95% Cl 1.75–5.91, p<0.001). AF was independently predictive of adverse outcome in multivariable analysis (HR 1.89; 95% CI 1.48–2.42, p<0.001).
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 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 | 0.004 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 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".