Abstract 198: Lifetime Clinical Benefit of Folic Acid Therapy for Primary Prevention of Stroke in Patients with Hypertension - Projection Based on the CSPPT
Bibliographic record
Abstract
Background: The CSPPT (China Stroke Primary Prevention Trial) demonstrated a significant risk reduction of first stroke in hypertensive patients treated with EPFA (enalapril plus folic acid) compared to those with enalapril alone, but the life time clinical benefit associated with the use of EPFA is unknown. In this study, we evaluated and quantified the net lifetime clinical benefit of EPFA vs. enalapril alone via assessing stroke-fee life expectancy. Methods: By establishing adjusted models for competing risks and an age-based time scale using data from 19, 053 participants of the CSPPT, we estimated lifetime incremental stroke-free life expectancy for EPFA vs. enalapril alone. Results: Compared with enalapril alone, lifetime EPFA treatment projected a mean stroke-free survival gain of 1.75 months, with an interquartile range months from 0.96 to 4.06 months and the maximum gain up to 12.95 months ( Table 1 ). Subgroup analysis showed greater gain in stroke-free survival in younger male patients, and those with lower baseline folate levels, higher systolic blood pressure, higher total cholesterol and blood glucose, and with methylenetetrahydrofolate reductase (MTHFR) C677T CT or TT genotype; the net benefit of stroke-free life expectancy varies from 3.5 months to 5.3 months among subgroup ( Figure 1 ). Conclusions: Our analyses projected that compared with enalapril alone, enalapril plus folic acid treatment in patients with hypertension is associated with a modest gain in lifetime stroke-free life expectancy. Younger male patients and those with lower baseline folate levels, and higher systolic blood pressure, total cholesterol and blood glucose, and the MTHFR C677T CT or TT genotype are expected to benefit most from the treatment.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| 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 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".