Abstract 13284: Cardiac Rehabilitation, Cardiorespiratory Fitness, and Risk of Incident Atrial Fibrillation in Patients With Coronary Artery Disease
Bibliographic record
Abstract
Introduction: Cardiorespiratory fitness (CRF) is an independent risk factor for cardiovascular morbidity and mortality. Cardiac rehabilitation (CR) can reduce cardiovascular risk factors and improve CRF. However, the relationship between CR, CRF, and risk of incident atrial fibrillation (AF) in patients with cardiovascular disease is less clear. Objectives: To examine the association of CR completion and associated CRF changes with the incidence of new-onset AF in patients referred to a CR program after coronary revascularization. Methods and Results: We included 11,662 patients without a history of AF, referred to CR after coronary revascularization between January 1996 to March 2016. The mean age was 60.9 ± 10.9 years and 80.6% were males. Incident AF was ascertained by linkage with provincial administrative data sources and the local ECG repository. Competing-risks regression was used to estimate the association of CR completion and CRF with incident AF, with death as a competing event. During a median follow-up of 4.8 years, 618 patients developed AF, and 638 died. In adjusted models, CR completion was not associated with the risk of incident AF [Hazard ratio (HR): 0.97; 95% confidence interval (CI): 0.83-1.15]. However, both baseline CRF [HR: 0.83; 95% CI: 0.76-0.90 per metabolic equivalent (MET)] and CRF gain (HR: 0.82; 95% CI: 0.72-0.94 per MET increase) for those who completed the CR program were associated with a lower risk of incident AF (Table 1). Conclusions: In patients referred to CR, CR completion was not associated with a reduced risk of incident AF. However, both higher baseline CRF and CR-associated CRF gains had a dose-dependent protective association with incident AF. Therefore, it is important to maximize CRF gains during the CR program. Further attention to AF-specific risk factor modification (i.e., obesity, sleep apnea, and alcohol) may be required to enhance CR program efficacy for this outcome, especially in patients with lower baseline CRF.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".