Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study
Bibliographic record
Abstract
<h2>Abstract</h2><h3>Background</h3> The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFR<sub>CT</sub>) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain. <h3>Methods</h3> Multicenter 3-year follow-up study of patients presenting with symptoms suggestive of new onset SAP who underwent first-line CTA evaluation and subsequent standard-of-care treatment. All patients had at least one ≥30 % coronary stenosis. A per-patient lowest FFR<sub>CT</sub>-value ≤0.80 represented an abnormal test result. Patients with FFR<sub>CT</sub> ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFR<sub>CT</sub>), all vessels with FFR<sub>CT</sub> ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFR<sub>CT</sub>) ≥1 vessels with FFR<sub>CT</sub> ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire. <h3>Results</h3> Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFR<sub>CT</sub> ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFR<sub>CT</sub> ≤0.80 vs > 0.80 associated to increased risk of recurrent angina, relative risk (RR): 1.82; 95 % CI: 1.31–2.52, p < 0.001. Risk of recurrent angina in CR-FFR<sub>CT</sub> (n = 135) was similar to patients with FFR<sub>CT</sub> >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62–1.40, p = 0.72, while IR-FFR<sub>CT</sub> (n = 90) and non-revascularized patients with FFR<sub>CT</sub> ≤0.80 (n = 285) had increased risk, 37 % vs 15 % RR: 2.50; 95 % CI: 1.68–3.73, p < 0.001 and 30 % vs 15 %, RR: 2.03; 95 % CI: 1.44–2.87, p < 0.001, respectively. Use of antianginal medication was similar across study groups. <h3>Conclusion</h3> In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFR<sub>CT</sub> provides information regarding risk of recurrent angina.
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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 | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.008 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".