Five-year morbidity and mortality of patients with ischemia with non-obstructive coronary artery disease and myocardial single-photon emission computed tomography perfusion defects
Bibliographic record
Abstract
Patients with angina and a positive single-photon emission computed tomography (SPECT) scan for reversible ischemia, with no or non-obstructive coronary artery disease (CAD) on invasive coronary angiography (ICA), represent a frequent clinical problem and predicting prognosis is challenging. This was a retrospective single-center study on patients who underwent elective ICA with angina and a positive SPECT with no or non-obstructive CAD over a seven-year period. Cardiovascular morbidity, mortality, and major adverse cardiac events were assessed during a follow-up of at least three years after ICA, with the aid of a telephone questionnaire. Data on all patients who underwent ICA in our hospital over a period of seven years (between January 1, 2011 and December 31, 2017) were analyzed. A total of 569 patients fulfilled the pre-specified criteria. In the telephone survey, 285 (50.1%) were successfully contacted and agreed to participate. Mean age was 67.6 (SD 8.8) years (35.4% female) and mean follow-up was 5.53 years (SD 1.85). Mortality was 1.7% (four patients, from non-cardiac causes), 1.7% underwent revascularization, 31 (10.9%) were hospitalized for cardiac reasons and 10.9% reported symptoms of heart failure (no patients with NYHA class>II). Twenty-one had arrhythmic events and only two had mild anginal symptoms. It was also noteworthy that mortality in the uncontacted group (12 out of 284, 4.2%), derived from public social security records, did not differ significantly from the contacted group. Patients with angina, a positive SPECT for reversible ischemia and no or non-obstructive CAD on ICA have excellent long-term cardiovascular prognosis for at least five years. Os doentes com angina e com cintigrafia de perfusão miocárdica positiva (isquemia reversível) sem DC ou com DC não obstrutiva na coronariografia (CI) representam um problema clínico frequente e o seu prognóstico constitui um desafio. Este estudo unicêntrico retrospetivo focou-se em doentes com angina e com cintigrafia de perfusão miocárdica positiva submetidos a coronariografia eletiva que revelou ausência de DC ou DC não obstrutiva durante um período de sete anos. Foi efetuada a avaliação da morbilidade, mortalidade cardiovasculares e de eventos cardíacos adversos major durante um período de seguimento de pelo menos três anos após a coronariografia, por questionário por telefone. Foram analisados os dados de todos os doentes submetidos a coronariografia durante um período de sete anos (de 1 de janeiro de 2011 a 31 de dezembro de 2017) no nosso hospital. Os doentes que preencheram os critérios pré-definidos foram 569. No inquérito realizado por telefone, 285 (50,1%) foram contactados com sucesso e acederam em participar. A idade média foi de 67,6 anos (SD8,8) (mulheres - 35,4%) e o período de seguimento médio foi 5,53 anos (SD1,85). A taxa de mortalidade foi de 1,7% (quatro doentes por causas não cardíacas) e de 1,7% de taxa de revascularização. Foram hospitalizados 31 (10,9%) doentes por causas cardíacas e 10,9% apresentaram sintomas de IC (nenhum doente com Classe>II NYHA); 21 tiveram eventos arrítmicos e apenas dois tiveram ligeiros sintomas de angina. É de salientar que a taxa de mortalidade no grupo não contactado (12 de 284, 4,2%) proveniente dos registos de saúde pública não diferiu significativamente da do grupo contactado. Os doentes com angina, com cintigrafia de perfusão miocárdica positiva (isquemia reversível) e com DC não obstrutiva ou sem DC tiveram um excelente prognóstico cardiovascular a longo prazo, durante pelo menos cinco anos.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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".