Common predictors of death in patients with STEMI and NSTEMI during 1st year of postinfarction period
Bibliographic record
Abstract
Abstract Aim Evaluation the levels of markers having highest prediction value regarding the risk of death in patients with STEMI and NSTEMI in 1 year after angioplasty. Material and methods The study enrolled 558 patients with STEMI and 553 pts with NSTEMI. From those who dead and survived 4 groups of pts have been selected by equal number 75 and homogenous concerning gender, age, comorbidities, cardiovascular risk factors and time of culprit coronary artery (s) revascularization. 62 markers referring to inflammation, endothelial and hemostasis dysfunction, NETosis, neuroendocrine activity and oxidative stress, cell injury and cardiovascular remodeling have been determined at admission (before coronary angioplasty) and at 24th hour after. Prediction power of markers regarding death risk was estimated by Odd’s ratio. Results Mortality rate was 17,03% (95 pts) in STEMI, and 14,8% (82 pts) in NSTEMI. In concern to Odd’s ratio having highest and similar power of death prediction should be emphasized following 9 markers determined at admission: IL-1β, selectin-E, endocan, von Willebrand/ADAMTS13 ratio, platelets microvesicles (CD62P), neutrophil elastase, myeloperoxidase, Ang 1-7/Ang II ratio and GDF-15. The Odd’s ratio of these markers was in a range of 2.26-2.97 (CI p<0,001). Remarkable, that in dead pts only have been found circulating activator autoantibodies against receptor ETA of ET-1 in 21 pts of STEMI (22.1%) and 16 pts of NSTEMI (19.5%). Noteworthy, in the top of reperfusion outrage on myocardium (first 24 hours) the increment of ischemia modified albumin (IMA) and H-FABP was significantly higher in dead vs survivors. More than that, the increasing ratio of these markers was higher in NSTEMI vs STEMI: 88.5 and 104.8% vs 65.5 and 85.2%, what in principle confirms the Heusch’s hypothesis viewing ischemic precondition influence on myocardial damage inherent to reperfusion impact. Conclusion Our study underlined at admission 9 circulating markers demonstrating a highest and similar Odd’s ratio of death risk in pts with either STEMI of NSTEMI which conceptually could be linked to key mechanisms of coronary microcirculatory dysfunction. Likewise, the increment of IMA and H-FABP from admission to 24 hours may reliably predict risk of death, and its higher level in NSTEMI indicates a more considerable contribution of reperfusion impact on myocardial damage in comparison with STEMI.
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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 | 0.000 |
| 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".