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TIME-TO-EVENT ANALYSIS OF MORTALITY AND STROKE IN TRIALS COMPARING TRANS-CATHETER AND SURGICAL AORTIC VALVE IMPLANTATION WITH DIFFERENT RISK PROFILES.

2024· article· en· W4405316358 on OpenAlexaff
Elisa Gastino, Matteo Scarpanti, Amédéo Anselmi, James M. Brophy, William E. Boden, Raffaele De Caterina, R. Almeida, Jean‐Philippe Verhoye, John Mandrola, Sanjay Kaul, Fabio Barili, Alessandro Parolari

Bibliographic record

VenueJournal of Cardiovascular Medicine · 2024
Typearticle
Languageen
FieldMedicine
TopicCardiac Valve Diseases and Treatments
Canadian institutionsMcGill University Health Centre
Fundersnot available
KeywordsMedicineStroke (engine)CardiologyAortic valveCatheterInternal medicineEvent (particle physics)Surgery

Abstract

fetched live from OpenAlex

Background: We compared the effectiveness of TAVI versus SAVR on a composite of death or stroke at 5-year follow-up within high, intermediate and low-risk profiles. Methods: From January 2007 to January 2024, we performed a systematic review of literature including randomized control trials (RCTs) comparing TAVI or SAVR with a minimum 1-year follow-up and reporting Kaplan-Meier analysis. The primary endpoint was the composite of all-cause mortality or stroke. Hazard ratios (HRs) and restricted mean survival time (RMST) differences within high, intermediate and low-risk profiles were estimated by reconstructing time-to-event data. Results: Seven trials were included (8418 participants). The incidence of composite endpoints increased with higher baseline risk profiles for both treatments. A time-variant effect was present with an early superiority of TAVI, as supported by a cumulative additional time-to-event of 0.73 months at 4 years driven by the high-risk group. The benefit of TAVI increased over time up to 5 years in high-risk patients (RMST difference 2.495. 95%CI: -0.019; 5.01. P-value 0.05). In intermediate and low-risk patients it showed a quadratic association with a smaller increase and attenuation of the observed benefit after 60 months (Low risk 0.813, 95%CI -0.177 1.802; p-value 0.107. Intermediate risk 0.076, 95%CI -1.131 1.282, p-value 0.902). Conclusions: In RCTs comparing TAVI vs SAVR, the benefits of TAVI differ according to the patient’s risk category. The advantage of TAVI over surgery progressively increases up to 5 years in high-risk patients. At 5 years in low and intermediate-risk there are no significant observed benefits.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.066
Threshold uncertainty score0.374

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.003
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.029
GPT teacher head0.353
Teacher spread0.324 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2024
Admission routes1
Has abstractyes

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