Abstract 2985: Impact of PCI in Patients with Recent Onset Severe Angina or Stabilized ACS Treated with Optimal Medical Therapy: a COURAGE Trial High Risk Subset
Bibliographic record
Abstract
Background: The COURAGE trial randomized 2,287 patients with stable coronary artery disease (CAD) to optimal medical therapy (OMT) with or without percutaneous coronary intervention (PCI). Eligibility criteria allowed entry of patients with recent onset, severe angina and recently stabilized acute coronary syndromes (ACS). We hypothesized that patients with recent onset, severe angina or recently stabilized ACS had higher risk for death or MI, and that this risk was reduced by PCI. Methods: High risk was defined as Canadian Cardiovascular Society class III angina with first onset of symptoms ≤ 2 months prior to enrollment, recently stabilized class IV angina, or recently stabilized ACS not treated with PCI. Persistent class IV angina patients were excluded. Patients were permitted to undergo revascularization during the trial as clinically indicated for unremitting angina or ACS. The chi square test was used for between group comparisons. Results: At baseline, 12% of COURAGE patients were classified as high risk. Within each treatment arm, high risk patients were more likely to suffer death or MI than non-high risk patients (OMT group, 26% vs. 17%, P=0.006; PCI group 24% vs. 18%, P=0.06). There was no significant difference between treatment arms for major cardiovascular events in patients at high risk (see Table ). As observed in the entire COURAGE cohort, revascularization was more frequent in high risk patients randomized to OMT compared with PCI (42% vs. 30%, P=0.04). Outcomes in High Risk Patients Randomized to OMT Alone or OMT + PCI Conclusions: The addition of PCI to OMT as an initial management strategy did not reduce death, MI or other major cardiovascular events in this high risk subset of COURAGE patients with recent onset severe angina or stabilized ACS.
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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".