25-Year Comparison of Coronary Lesions Anatomy in Two Cohorts of French Canadians with Familial Hypercholesterolemia
Bibliographic record
Abstract
Background: Over the past decades, new treatments and guidelines have been introduced for the screening and management of familial hypercholesterolemia (FH). However, the impact of these medical and scientific advances on the characteristics and burden of coronary lesions over time in FH remains poorly documented. Objective: The primary goal of this study is to determine the characteristics of coronary lesions in HeFH patients who underwent coronary angiography within two distinct timeframes: the last five years versus those who had the procedure at the same hospital 25 years earlier. Methods: The characteristics of coronary lesions in 108 HeFH patients who consecutively underwent coronary angiography for CAD between 2017 and 2022 (2022 cohort) were compared to those of 240 patients who had an angiography between 1995 and 1998 (1998 cohort). Results: Compared to 1998, FH patients requiring coronary angiography were proportionally less numerous and significantly older in 2022 (p < 0.001). Although the number of coronary lesions (2.5 ± 1.5 in both cohorts) and the proportions of multi-vessel (70.4% vs. 70.2%), three-vessel (29.6% vs. 30.2%) and left main involvement (15.7% vs. 16.0%) did not differ significantly in 2022 compared to 1998, proximal involvement (57.7% vs. 79.5%) and total occlusion (26.8% vs. 52.7%) were less frequently observed in 2022 (p < 0.001) and referral to bypass grafting (CABG) decreased by >50% from 1998 to 2022 (15.5% vs. 39.8% p < 0.001). Conclusions: Over a 25-year period, the incidence of total coronary artery occlusion and the need for CABG among adults with FH from a high-prevalence founder population were reduced by more than 50% and occurred in older ages. However, the absence of major improvement of coronary anatomy severity underscores the persistently high cardiovascular risk in FH patients.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".