TAVI patients with bystander coronary artery disease should receive PCI: pros and cons
Bibliographic record
Abstract
The coexistence of coronary artery disease (CAD) and severe aortic stenosis is a frequent and complex clinical scenario, affecting up to 80% of patients undergoing transcatheter aortic valve implantation (TAVI). As the profile of TAVI candidates evolves − with younger patients and longer life expectancies − the prognostic implications of CAD become increasingly relevant. In addition, while aortic stenosis is a life-threatening condition requiring treatment to reduce overall mortality, the management of concomitant CAD is also crucial to improve symptoms. Treating significant CAD may undermine the benefits of TAVI, leading to persistent angina, adverse cardiac events over time, and reduced quality of life. However, stable CAD rarely necessitates urgent intervention, and percutaneous coronary intervention (PCI) carries potential risks (including bleeding, stroke, and acute kidney injury) without clear benefits in this setting. Although two randomised trials investigated this delicate issue, whether treating bystander CAD in patients undergoing TAVI is associated with favourable prognostic implications or merely adds procedural risks remains a matter of debate.
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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 | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".