Effect of New Evidence on Antithrombotic Therapies in Atrial Fibrillation Patients Who Undergo Percutaneous Coronary Intervention in Alberta, Canada
Bibliographic record
Abstract
Background Trials have addressed the combined use of direct oral anticoagulants (DOACs) and antiplatelets in atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI). These trials may have changed prescribing patterns. Methods This administrative audit of Albertans with AF undergoing PCI described antithrombotic therapy before vs after publication of the PIONEER AF-PCI (An O p en-label, Randomized, Controlled, Multicenter Study Explor i ng Tw o Treatme n t Strat e gi e s of R ivaroxaban and a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy in Patients With A trial F ibrillation Who Undergo P ercutaneous C oronary I ntervention) trial results. Results Cohorts were similar before ( n = 597) and after ( n = 708) trial publication: median age 72 years; 23% female; 63% with acute coronary syndrome; and 22% with bleeding history. Anticoagulant use increased by 7.0% ( P = 0.01) after; with DOAC use increasing by 24.9% and warfarin use decreasing by 17.5% ( P < 0.0001). DOAC use was associated with being in the "after" cohort (odds ratio 5.42, 95% confidence interval 3.75-7.82, P < 0.0001). Conclusions Significantly more patients were prescribed anticoagulation therapy after the publication of the results of the PIONEER AF-PCI trial than before, and the choice of agent favoured DOAC over warfarin. Almost half of patients were not on anticoagulants, a situation that requires further investigation, to ensure that AF patients are being optimally managed post-PCI.
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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 | 0.003 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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".