Variations of the Extent of Obstructive Coronary Artery Disease Among Canadian Immigrants
Bibliographic record
Abstract
BACKGROUND: An increasing proportion of immigrants are residing in developed countries, but little is known about the extent of their obstructive coronary artery disease (CAD). Our objective was to evaluate the association between immigrant status and CAD among immigrants. METHODS AND RESULTS: Initial coronary angiography performed for stable CAD from 2012 to 2021 in Ontario, Canada was examined. Immigrants were categorized by their country of birth into 7 world regions. The primary outcome was the rate of obstructive CAD, defined as the presence of left main stenosis ≥50% or major epicardial vessel stenosis ≥70%. Multivariable logistic regression analyses were conducted to compare the adjusted odds of obstructive CAD among long-term residents and immigrants, and then within immigrant groups. Our cohort included 208 363 long-term residents and 36 139 immigrants; the immigrants were substantially younger than the long-term residents (61.3 versus 66.6 years). Male immigrants had 12.0% higher adjusted odds (95% CI, 1.17-1.24) of having obstructive CAD than long-term residents, whereas no significant difference was observed among female immigrants and long-term residents. There was also substantial variation in CAD among immigrants based on their country of origin. For example, male immigrants from South Asia had 49.0% higher adjusted odds of having CAD, whereas patients from Africa (0.75) and the Caribbean (0.63) had lower adjusted odds. CONCLUSIONS: We observed earlier presentations for cardiac catheterization among immigrants with stable CAD and higher adjusted odds of having obstructive CAD among male immigrants compared with long-term residents of Canada. Rates of obstructive CAD varied significantly by their region of birth.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".