Commentary: Postcoronary artery bypass grafting treatment of dyslipidemia: Better hit those targets!
Bibliographic record
Abstract
Central MessageSimply treating dyslipidemia after CABG is not good enough; better hit those targets to improve outcomes after CABG.See Article page 195. Secondary prevention is essential to optimize the long-term outcomes of patients who undergo coronary artery bypass grafting (CABG), and treatment of dyslipidemia is a key component of this prophylactic approach. In this paper from Lim and colleagues,1Lim K. Wong C.H.M. Lee A.L.Y. Fujikawa T. Wong R.H.L. Influence of cholesterol level on long-term survival and cardiac events after surgical coronary revascularization.J Thorac Cardiovasc Surg Open. 2022; 10: 195-203Scopus (1) Google Scholar 309 patients operated in 2007 to 2008 were followed a mean of 12.5 years and underwent a total number of 5774 lipid profile measurements, or 1.53 measurements per patient-year of follow-up. The key findings emanating from this dataset are that less than 25% of patients achieved a low-density lipoprotein cholesterol level below 1.8 mmol/L, highlighting a significant gap between guidelines and clinical practice and that persistent lipid abnormalities are often overlooked. Considering the benefits of optimal lipid control on cardiac events and cardiac death after CABG, 21.7% and 6.8%, respectively, in this cohort, this information should act as a wake-up call to physicians following and treating risk factors after surgical myocardial revascularization. Despite the limitations brought about by the lack of data on timing of initiation and drug adherence, the variations in type and dosage of statin molecules as well as crossovers from one drug to another as well as in the intensity of treatment, one thing should be clear to all: Simply treating dyslipidemia after CABG is not good enough—better hit those targets! Influence of cholesterol level on long-term survival and cardiac events after surgical coronary revascularizationJTCVS OpenVol. 10PreviewStatins have been shown to delay the inevitable progression of atherosclerosis in native coronaries and saphenous vein grafts, thereby reducing ischemic events after surgical coronary revascularization. However, there is significant controversy as to whether titrating statin therapy to concrete cholesterol targets is appropriate. Full-Text PDF Open Access
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".