Abstract 13402: Outcomes of Cardiac Resynchronization Therapy in Ischemic versus Non-Ischemic Cardiomyopathy: A Patient-Level Meta-Analysis of 7 Randomized Clinical Trials
Bibliographic record
Abstract
Background: Data on whether CRT results in better clinical and echocardiographic outcomes in patients with NICM versus patients with ICM are conflicting. Objective: To determine if there are differences in clinical and echocardiographic outcomes of CRT in patients with ICM versus NICM. Methods: We analyzed patient-level data from 7 CRT trials (MIRACLE, MIRACLE-ICD, MIRACLE-ICD II, COMPANION, RAFT, MADIT-CRT, REVERSE) using Bayesian Hierarchical Weibull survival regression modeling, adjusted for baseline characteristics and presence of an ICD, to determine the effect of etiology of cardiac dysfunction on time to all-cause mortality alone and in combination with heart failure hospitalization (HFH). Kaplan-Meier (KM) survival curves were developed with unadjusted frequentist analyses. Linear regression was used to assess the effect of etiology of cardiomyopathy on echocardiographic measurements. Results: Of the 6252 patients included, 1535 (25%) were women, the median age was 66 (IQR 58-73), 3704 (59%) had ICM, and 3778 (60%) received CRT. Of those who received CRT, 2207 (58%) patients had ICM. Overall, CRT increased the time to HFH or death (hazard ratio (HR) 0.67, 95% credible interval (CrI) 0.56-0.82, p<0.001) with no difference by etiology (HR ratio 1.06, CrI 0.87-1.29, p=0.57). CRT increased the time to death (HR 0.71, CrI 0.55-0.93, p=0.019) with no difference by etiology (HR ratio 1.06, CrI 0.80-1.43, p=0.70), although overall event rate was higher in ICM. CRT in ICM increased the median survival and time free of HFH (70 versus 50 months, p=0.0015) and had borderline effect in NICM (p=0.05) (Figure). Echocardiographic data that were available for 2430 (39%) patients showed that CRT improvements in LVEF, LVEDD, and LVESD were larger for patients with NICM. Conclusion: CRT increased the time to HFH or death independent of etiology of cardiac dysfunction. However, CRT led to greater increases in LVEF and reductions in ventricular dimensions for patients with NICM.
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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 | 0.023 | 0.033 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.040 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 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".