Incidence, Predictors, and Outcomes of Complete Angina Relief in Symptomatic Patients in the ISCHEMIA Trial
Bibliographic record
Abstract
BACKGROUND: Patients with chronic coronary disease experience less angina with revascularization plus optimal medical therapy compared with optimal medical therapy alone. However, patients may prefer to better understand their individual likelihood of complete angina relief associated with each treatment approach before selecting a strategy. We therefore sought to determine the incidence, predictors, and outcomes of complete angina relief in symptomatic patients treated with invasive management using revascularization plus optimal medical therapy or conservative therapy with optimal medical therapy alone in the ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) trial. METHODS: Angina was assessed using the Seattle Angina Questionnaire Angina Frequency (AF) score. We analyzed patients in the invasive management treatment arm with angina at baseline (Seattle Angina Questionnaire Angina Frequency <100) who underwent revascularization and all patients in the conservative therapy arm with angina at baseline. The primary outcome was angina status at 12 months defined as a Seattle Angina Questionnaire Angina Frequency=100 (complete angina relief) or Seattle Angina Questionnaire Angina Frequency <100 (persistent angina). The association of angina status with the composite of cardiovascular death/myocardial infarction was assessed at 5 years. RESULTS: Among 1376 patients in the conservative therapy arm with angina at baseline, 50% experienced complete angina relief at 12 months. Independent predictors included older age, male sex, recent angina onset, and less baseline angina. Among 1158 patients who underwent revascularization, 70% achieved complete angina relief. Predictors included younger age, nonsmoking, coronary artery bypass graft, and less baseline angina. Cardiovascular death/myocardial infarction rates at 5 years did not differ between patients with or without complete angina relief. CONCLUSIONS: Complete angina relief at 12 months in symptomatic patients with chronic coronary disease was achieved in 70% of patients undergoing revascularization and 50% of patients treated ith conservative therapy and did not influence cardiovascular death/myocardial infarction outcomes. REGISTRATION: https://ischemiatrial.org/; ISCHEMIA Trial. Accession Number HLB02742323a.
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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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".