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Angiographic types of spontaneous coronary dissection and their impact on long-term outcome

2025· article· en· W7127600887 on OpenAlexaff
Desirée Wussler, M Kang, T Grewal, John Mancini, J Saw

Bibliographic record

VenueEuropean Heart Journal · 2025
Typearticle
Languageen
FieldMedicine
TopicCardiovascular Issues in Pregnancy
Canadian institutionsVancouver General Hospital
Fundersnot available
KeywordsScadMyocardial infarctionClinical endpointAcute coronary syndromeArteryDissection (medical)

Abstract

fetched live from OpenAlex

Abstract Background Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction (MI). However, it remains unclear whether and in which extent the different angiographic types of SCAD (type 1-3) impact patients´ outcome. Methods We analyzed data from all patients included in our national SCAD study. For this analysis, only patients with angiographically classified type of SCAD and complete follow-up were eligible. Patients with different types of SCAD during their index event were excluded. Cumulative rate of recurrent MI was the primary endpoint and assessed by Kaplan-Meier curves. Results Of 684 eligible patients, SCAD type 2 during index event was the most common diagnosis affecting 478 (69.8%) patients. SCAD type 1 was more common than SCAD type 3 (150 patients (22.0%) versus 56 patients (8.2%), respectively). Within the long-term follow-up of 1800 days, 57 patients (7.9%) had a recurrent MI of which 22 patients (38.6%) had recurrent SCAD. Assessment of cumulative rate of recurrent MI showed a significant gradient within 1800 days of long-term follow-up over the 3 predefined types of SCAD (p=0.04, Figure 1). Patients with type 1 SCAD during their index event had the highest rate of recurrent MI when compared to patients with type 2 and type 3 SCAD (12.0% versus 6.7% versus 5.3%, respectively). There was a statistically significant difference when comparing the cumulative rate of recurrent MI in patients with type 1 and type 2 SCAD during 1800 days of follow-up (p=0.01). Conclusion The angiographic type of SCAD had a significant impact on the cumulative rate of recurrent MI during long-term follow-up. Patients with initial type 1 SCAD had the highest event rate when compared to patients with type 2 and 3 SCAD.Cumulative event rate over 1800 days for

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 imitation

Not 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.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.009

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0010.001
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.022
GPT teacher head0.318
Teacher spread0.296 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations0
Published2025
Admission routes1
Has abstractyes

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