Persistent chest pain trends at 3 years in women with INOCA vs. obstructive CAD: results from the NHLBI-sponsored women’s ischemia syndrome evaluation (WISE)
Bibliographic record
Abstract
AIMS: Individuals with suspected ischaemia but no obstructive coronary arteries (INOCA) experience persistent chest pain (PChP) at rates comparable to those with obstructive coronary artery disease (CAD). We analysed the National Heart, Lung, and Blood Institute-sponsored Women's Ischaemia Syndrome Evaluation (WISE) (NCT00000554) to compare patterns in chest pain persistence, cardiac medication use, and major adverse cardiovascular events (MACE) among women with INOCA and those with obstructive CAD. METHODS AND RESULTS: There were 624 participants from WISE who met the inclusion criteria for this analysis (19% non-white, mean age = 58.0 years). Chest pain status was classified based on symptoms reported during the first 3 years of follow-up. Baseline predictors of 3-year chest pain status were assessed by Chi-square, and a log-rank test was used to compare 6-year outcomes by status. At 3 years, overall 26% of participants had persistent, 14% had intermediate, 27% had recurrent, and 34% had resolved chest pain. PChP prevalence was comparable in the INOCA group and the obstructive CAD groups (27% vs. 24%, P = 0.06). MACE occurrence was not significantly associated with 3-year chest pain status in either the INOCA or obstructive CAD groups. However, hospitalization for angina was associated with chest pain status (P < 0.001). CONCLUSION: Women with INOCA experience a comparable burden of chest pain to those with obstructive CAD, yet lower rates of medical therapy at baseline and over time. Based on our findings, chest pain status at 3 years predicts angina hospitalizations but not MACE in women with or without obstructive CAD.
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".