Increased Cardiovascular Events in Paget’s Disease of Bone, a Study from the CARTaGENE Cohort
Bibliographic record
Abstract
Objectives Paget’s disease of bone is a focal late-onset chronic disorder of bone remodeling, characterized by bone resorption followed by compensatory bone formation. This disease is most often asymptomatic, but an increase in cardiovascular events has been observed over time in this population. We aimed to evaluate the association between Paget’s disease and the risk of cardiovascular events (CVE) within the CARTaGENE cohort. We also determined the association between arterial stiffness parameters and the risk of CVE, and the association between Paget’s disease and arterial stiffness. Methods We used data collected from the CARTaGENE cohort, a population cohort including nearly 20,000 men and women aged between 40 and 69 years, recruited in 2009/2010 in the province of Quebec, and followed for 10 years, for the study of chronic diseases. We evaluated the risk of CVE (ie, myocardial infarction, stroke, coronary heart disease, coronary revascularization, heart failure, peripheral arterial disease, cardiovascular mortality) during follow-up associated with Paget’s disease with Cox proportional hazard models and Kaplan-Meier survival curves. All estimates were adjusted for sex, diabetes, hypertension, and smoking. We evaluated the association between Paget’s disease and arterial stiffness, measured by central augmentation index, with linear regression models. Lastly, in pagetic participants, we evaluated the association between arterial stiffness and the risk of CVE at follow-up with Cox regression. A p-value <0.05 was considered significant. These analyzes were carried out by SAS 9.4. Results Among 19 990 participants, we identified 101 (0.5%) patients with Paget’s disease (mean age 48 ± 8 years, 46% of women), diagnosed from 1991 to 2021. Paget’s disease was associated with an increased risk of CVE during follow-up [95% confidence interval (CI) HR 1.48 (1,05-2,09) p<0.0028] (Figure 1). No significant association was found between arterial stiffness in Paget’s disease and a cardiovascular event [95% confidence interval (CI) HR 2.90 (0.007- 1275.92)]. Lastly, no association was found between Paget’s disease and arterial stiffness (R2 = 0.22, β = 0.0034, p = 0.75). Figure 1: Survival curve of cardiovascular events from birth according to Paget’s disease status during life. Conclusion Paget’s disease is associated with an increased risk of CVE. However, arterial stiffness, as measured by the central augmentation index, is not associated with this increased risk and Paget’s disease is not associated with arterial stiffness in our cohort.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".