P3492Nonagenarians with acute myocardial infarction; invasive versus conservative strategy
Bibliographic record
Abstract
Background: There is limited data supporting invasive strategy in nonagenarians with acute myocardial infarction (AMI). We aimed to investigate performing percutaneous coronary intervention (PCI) is beneficial in these frail population. Methods: We retrospectively analyzed 41 nonagenarians with AMI (both ST-segment elevation MI and non-ST segment MI) between 2006 and 2015 in single center. We assessed 30-day and 1-year mortality according to treatment strategy. Results: Among study subjects, 24 (59%) were treated with PCI (PCI group) and 17 (41%) with conservative management (conservative group) upon clinician's discretion. Median follow-up duration was 30 months (0 to 74). Age, sex, smoking, diabetes, dyslipidemia, history of coronary artery disease were not different significantly between the two groups. Body mass index (BMI) was significantly higher in PCI group (21.19 versus 18.97, P<0.05). Thirty-day mortality was lower in PCI group than in conservative group (17% versus 65%, respectively, P<0.001). One-year mortality was also lower in PCI group than in conservative group (21% versus 76%, respectively,P<0.001). Cox proportional hazard regression analysis was performed to adjust the effect of age, sex, BMI, ejection fraction, renal insufficiency and killip class on death. Conservative group had about 6 times higher risk of death (adjusted HR: 6.36, 95% CI: 2.19–18.47, P<0.001). In subgroup with Killip class 1–3 (36), 30-day and 1-year mortality were still higher in conservative group (13% versus 54% in 30-day, P<0.001; 17% versus 69% in 1-year, p<0.001). In subgroup of 30-day survivors, there was no significant difference in cumurative mortality rate between the two groups, indicating that mortality difference was mainly decided within the first 30 days after AMI.
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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 | 0.000 | 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 | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".