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Record W4405323209 · doi:10.1016/j.jacadv.2024.101440

The Relationship Between Quantitative Ischemia, Early Revascularization, and Major Adverse Cardiovascular Events

2024· article· en· W4405323209 on OpenAlexaff
Robert J.H. Miller, Bryan Bednarski, Yujie Cui, Vinícius F. Calsavara, Krishna Patel, Alan Rozanski, Joanna X. Liang, Valerie Builoff, Wanda Acampa, Timothy M. Bateman, Marcelo F. Di Carli, Sharmila Dorbala, Andrew J. Einstein, Matthews Fish, M. Timothy Hauser, Philipp A. Kaufmann, Edward J. Miller, Terrence D. Ruddy, Tali Sharir, Albert J. Sinusas, Damini Dey, Daniel S. Berman, Piotr J. Slomka

Bibliographic record

VenueJACC Advances · 2024
Typearticle
Languageen
FieldMedicine
TopicCardiac Imaging and Diagnostics
Canadian institutionsUniversity of OttawaArtificial Intelligence in Medicine (Canada)University of Calgary
FundersNational Center for Advancing Translational SciencesNational Heart, Lung, and Blood Institute
KeywordsRevascularizationCardiologyInternal medicineMedicineIschemiaAdverse effectMyocardial infarction

Abstract

fetched live from OpenAlex

Background: Observational data have suggested that patients with moderate to severe ischemia benefit from revascularization. However, this was not confirmed in a large, randomized trial. Objectives: Using a contemporary, multicenter registry, the authors evaluated differences in the association between quantitative ischemia, revascularization, and outcomes across important subgroups. Methods: Patients who underwent myocardial perfusion imaging in 12 centers were included in this retrospective analysis. The population was divided into original (2009-2014) and recent (2014-2021) registry sites. Early revascularization was defined as any revascularization within 90 days of myocardial perfusion imaging. A propensity score was developed to adjust for nonrandomization. Propensity score-adjusted survival analyses were used to evaluate the associations between quantitative ischemia, early revascularization, and death or myocardial infarction (MI) to identify at what severity of ischemia the HR for early revascularization crosses 1 (threshold for potential benefit). Results: < 0.001). The threshold for ischemia, above which patients may benefit from revascularization, was higher in more recent patients (14.0% vs 6.5%), but similar in female (>10.0%) and male patients (>8.6%). Conclusions: Early revascularization was associated with reduced risk in patients with a higher burden of quantitative ischemia in more recent populations. These findings suggest that methods integrating more factors than just ischemia are needed to improve patient selection for revascularization.

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)0.000
metaresearch head score (Gemma)0.002
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 score0.310
Threshold uncertainty score0.315

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
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 head0.024
GPT teacher head0.314
Teacher spread0.290 · 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

Citations4
Published2024
Admission routes1
Has abstractyes

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