Abnormal Cardiac Biomarkers in Patients with Systemic Lupus Erythematosus and No Prior Heart Disease: The Role of Endomyocardial Biopsy
Bibliographic record
Abstract
To the Editor: Tselios, et al reported in their recent study that patients with systemic lupus erythematosus (SLE) who receive prolonged antimalarial (AM) treatment are at increased risk for elevated cardiac biomarkers [brain natriuretic peptide (BNP) and high-sensitivity cardiac troponin I (HS-cTnI)], particularly when persistently elevated creatine phosphokinase (CPK) is present1. Among a well-characterized SLE cohort of 179 patients, the authors found that 16 (all without cardiac disease, renal failure, or pulmonary arterial hypertension) presented an increase of at least 1 cardiac biomarker. Prolonged AM use (> 5.6 yrs) was found to be associated with these laboratory abnormalities, regardless of age and SLE disease duration1. Regarding the potential reason underlying these findings, the authors speculated that AM deposition in muscle tissue (expressed with chronic CPK elevation) could not be restricted to skeletal muscles, and the drug could also accumulate within the myocardium. Therefore, they proposed the evaluation of these cardiac biomarkers as a screening tool for patients with SLE receiving AM … Address correspondence to Dr. G. De Luca, Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy. E-mail: deluca.giacomo{at}hsr.it
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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 | 0.004 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 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".