SIGNIFICANCE OF CANADA ACUTE CORONARY SYNDROME RISK SCORE IN EMERGENCY PERCUTANEOUS REVASCULARIZATION FOR THE PREDICTION OF CONTRAST INDUCED NEPHROPATHY
Bibliographic record
Abstract
Objectives: This study was conducted to compare the accuracy of Canada Acute Coronary Syndrome (C-ACS) score against Mehran risk score (MRS) in primary percutaneous coronary intervention (PCI) patients for risk stratification of contrast induced nephropathy (CIN) at a tertiary care cardiac hospital. Methodology: In this study we included adult patients presented with chief presenting complaint of typical chest pain to emergency department within 12 hours of onset of symptoms, diagnosed with ST-segment elevation myocardial infarction (STEMI) and taken to the catheterization laboratory for primary PCI. Two scores MRS and C-ACS were computed and CIN was defined based on the variations in creatinine level, absolute 0.5 mg/dL or relative 25% increase at 48-72 hours. Results: Study included a total of 593 patients with mean age of 52.22±11.1 years and 488(82.3%) were male patients. A total of 53(8.9%) patients developed CIN after primary PCI. The area under the curve (AUC) was 0.745 [0.675-0.815] and 0. 647 [0.560-0.733] for MRS and C-ACS score respectively. The threshold value C-ACS ≥ 1 has sensitivity of 47.2% [33.3%-61.4%] and specificity of 80.2% [76.6%-83.5%]. Similarly, MRS ≥6.5 has sensitivity of 64.2% [49.8%-76.9%] and specificity of 75% [71.1%-78.6%]. Conclusion: C-ACS score is found to be less sensitive but more specific in identifying patients at high risk of CIN. Predictive value of C-ACS was observed to be lower than that of MRS. In the tradeoff of simplicity and accuracy, clinicians may consider accuracy and prefer MRS over C-ACS for the risk stratification of CIN.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 | 0.001 |
| 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".