Impact of Coronary Sinus Reducer on Angina Symptoms in Patients With Myocardial Ischemia Without Obstructive Coronary Artery Disease
Bibliographic record
Abstract
BACKGROUND: Coronary sinus (CS) Reducer implantation shows favorable results in alleviating angina symptoms in patients with obstructive coronary artery disease (CAD) with non-revascularizable lesions. Whether CS Reducer is effective also in patients without obstructive epicardial CAD remains unsettled. AIMS: We sought to assess the potential benefits of the CS narrowing in patients without obstructive presenting with refractory angina. METHODS: Consecutive refractory angina patients, with objective evidence of myocardial ischemia despite optimal medical therapy (OMT), who underwent CS Reducer implantation, were enrolled in an international registry. Study cohort was divided into two groups: patients with non-obstructive CAD (< 50% narrowing in all epicardial coronary arteries or a negative intracoronary fractional flow reserve test in case of intermediate lesions), and patients with obstructive CAD. The study outcome was the improvement of the Canadian Cardiovascular Society (CCS) angina score at 12-month follow-up in both groups of patients. RESULTS: Of 285 enrolled patients with successful CS Reducer implantation, 46 patients (16%) had non-obstructive CAD and 239 patients (84%) had obstructive CAD. Baseline CCS angina score was similar in both groups (2.9 ± 0.5 vs. 2.9 ± 0.6, p = 0.884). At 12-month follow-up, the improvement in CCS angina score was similar in both groups (-1.4 ± 0.8 vs. -1.3 ± 0.9 vs. p = 0.67). Both groups had the same CCS angina score at 12-month follow-up (1.6 ± 0.8 p = 0.80). Improvement of ≥ 2 CCS classes were 41.9% and 45.1% in patients with non-obstructive and obstructive CAD, respectively, p = 0.6746. CONCLUSIONS: In patients with refractory angina and myocardial ischemia, CS Reducer implantation improves angina symptoms in patients with myocardial ischemia with and without obstructive CAD.
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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 | 0.001 |
| 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".