Corticosteroid use and the risk of acute myocardial infarction in patients with chronic obstructive pulmonary disease
Bibliographic record
Abstract
Patients with chronic obstructive pulmonary disease (COPD) use medications known to have cardiovascular effects. Yet, the burden of cardiovascular disease in COPD and the effect of corticosteroids used in its treatment have not been described. We used the Saskatchewan health services database to form a population-based cohort of 5648 patients treated for COPD and followed during 1990-99. Cardiovascular morbidity and mortality were higher in our cohort than in the general population (Standardized Rate Ratio=l .9 and 2.0 respectively). Ischemic heart disease (19.6 per 1000 person-years) was a more frequent cause of death than COPD itself (15.5 per 1000 person-years). In a nested case-control analysis, doses of oral corticosteroids larger than 5 mg of prednisone per day increased the risk of AMI (Rate Ratio=l .81 ; 95%CI 1.05 -3.13). However, a réduction of the risk of AMI was observed with doses of inhaled corticosteroids ranging from 50 to 200 micrograms per day (Rate Ratio= 0.68; 95%CI 0.47 - 0.99). The burden of cardiovascular disease in COPD patients may be greater than that of the lung disease itself. The effects of corticosteroids on the cardiovascular system should be taken into account.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| 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".