Implications of Contemporary Clinical Trials General Cardiology Perspective: Decision Making Regarding Revascularization of Patients With Type 2 Diabetes Mellitus and Cardiovascular Disease in the Bypass Angioplasty
Bibliographic record
Abstract
The interest in the diabetic population undergoing coro-nary revascularization began with the reporting of the Bypass Angioplasty Revascularization Investigation (BARI) trial in 1996.1 In patients with multivessel disease, a post hoc analysis demonstrated a significant survival advantage for patients in the coronary artery bypass grafting (CABG) arm compared with those undergoing balloon angioplasty. This striking finding sensitized the cardiovascular community to the unique nature of diabetic coronary disease. A comprehen-sive meta-analysis of percutaneous coronary intervention (PCI) versus CABG trials before the drug-eluting era has confirmed the BARI findings.2 Over the next decade, there were tremendous advances in medical risk factor modifica-tion, particularly the widespread use of statin drugs and improvements in therapies for glycemic control. The BARI 2 Diabetes (BARI 2D) investigators posed the next important question about optimal management of coronary disease in patients with less severe symptomatology than those enrolled in the multivessel PCI versus CABG trials.3 About 80 % of patients were either asymptomatic or had stable class I/II Canadian Cardiovascular Society angina. In this trial, the comparison was now between prompt revascularization on top of optimal medical therapy (OMT) versus OMT alone. BARI 2D heralded in a new era in National Heart, Lung, and Blood Institute–sponsored trials by exclusively studying pa-tients with type 2 diabetes mellitus. BARI 2D demonstrated no difference in 5-year mortality between the prompt revas-cularization and OMT alone arms (11.7 % versus 12.2%; P0.97) as well as no difference in 5-year rates of the combined end point of death, myocardial infarction, and stroke (22.8 % versus 24.1%; P0.70).
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.335 | 0.678 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.011 | 0.006 |
| Bibliometrics | 0.007 | 0.011 |
| Science and technology studies | 0.003 | 0.018 |
| Scholarly communication | 0.026 | 0.019 |
| Open science | 0.010 | 0.008 |
| Research integrity | 0.036 | 0.040 |
| Insufficient payload (model declined to judge) | 0.026 | 0.006 |
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".