Clinical significance of a new diagnosis of atrial fibrillation in patients with vascular disease
Bibliographic record
Abstract
BACKGROUND: The Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial enrolled patients with vascular disease but excluded patients requiring oral anticoagulation. OBJECTIVE: We aimed to explore the clinical significance of a new diagnosis of atrial fibrillation (AF) during follow-up. METHODS: New AF was identified from hospitalization, study drug discontinuation, and adverse event reports. Multivariable Cox regression was used to determine risk factors for new AF. Time-updated covariate analysis was used to study the association of new AF with outcomes. RESULTS: During a mean follow-up of 23 months, 655 of 27,395 participants (2.4%) were diagnosed with AF (incidence, 1.3 per 100 patient-years). In adjusted analyses, advanced age, male sex, White ethnicity, higher body mass index, higher systolic blood pressure, heart failure, and prior myocardial infarction were associated with new AF. Compared with participants without a new diagnosis of AF during follow-up or before receiving a diagnosis of new AF, participants were at increased risk of a composite outcome of cardiovascular death, stroke, or myocardial infarction after a new diagnosis of AF (8.8 vs 2.4 per 100 patient-years; hazard ratio [HR], 3.66; 95% confidence interval [CI], 2.81-4.75). Risk increases with new AF were also observed for hospitalization for heart failure (6.8 vs 0.8 per 100 patient-years; HR, 8.64; 95% CI, 6.31-11.83) and major bleeding (3.9 vs 1.3 per 100 patient-years; HR, 3.18; 95% CI, 2.15-4.69). CONCLUSION: In patients with vascular disease, a new diagnosis of AF was associated with a marked increase in risk of adverse outcomes, especially hospitalization for heart failure.
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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 | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".