Correlation between the AHCPR (Agency For Health Care Policy and Research) risk stratification and angiographic morphology in non-ST-segment elevation acute coronary syndrome [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(2): 105-113 | DOI: 10.5543/tkda.2011.00910

Correlation between the AHCPR (Agency For Health Care Policy and Research) risk stratification and angiographic morphology in non-ST-segment elevation acute coronary syndrome

Ahmet Yıldız1, Uğur Coşkun1, Kadriye Orta Kılıçkesmez1, Murat Başkurt1, Cem Bostan1, Alev Arat Özkan1, Barış Ökçün1, Tevfik Gürmen1, Seçkin Pehlivanoğlu2, Rasim Enar3
1Istanbul University, Institute of Cardiology, Istanbul, Turkey.
2Department of Cardiology, Baskent University, Istanbul, Turkey.
3Istanbul University Cerrahpasa School of Medicine, Department of Cardiology, Istanbul, Turkey.


OBJECTIVES
Risk stratification in acute coronary syndromes is an important diagnostic tool guiding future therapy. We evaluated the correlation between the AHCPR (Agency for Health Care Policy and Research) risk classification and angiographic morphology in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

STUDY DESIGN
A total of 163 patients hospitalized with the diagnosis of NSTE-ACS were prospectively enrolled. All the patients underwent AHCPR risk analysis followed by coronary angiography. Based on the AHCPR system, the patients were classified as low (n=25, mean age 55±10 years), intermediate (n=55, mean age 58±10 years), and high (n=83, mean age 61±11 years) risk groups.

RESULTS
The three groups were similar with regard to gender, age, and coronary heart disease risk factors (p>0.05). Comparison of the high-risk group with intermediate+low-risk group with regard to lesion morphology showed significantly higher rates of complex lesions (31.9% vs. 4.0%, p=0.001), total occlusion (23.2% vs. 0%, p=0.001), and intracoronary thrombosis (13% vs. 2%, p=0.02) in the high-risk group. In univariate analysis, high risk was significantly associated with the presence of complex lesion, total occlusion, intracoronary thrombosis, and TIMI flow < III. Of these, only the presence of complex lesion (p=0.005) and TIMI flow

CONCLUSION
Our findings show that the incidence of high-risk coronary morphology is increased in NSTE-ACS patients having a high-risk profile according to the AHCPR classification.

Keywords: Angina, unstable/classification, coronary angiography, coronary artery disease; coronary stenosis; coronary thrombosis; myocardial infarction; risk assessment/methods; severity of illness index

How to cite this article
Ahmet Yıldız, Uğur Coşkun, Kadriye Orta Kılıçkesmez, Murat Başkurt, Cem Bostan, Alev Arat Özkan, Barış Ökçün, Tevfik Gürmen, Seçkin Pehlivanoğlu, Rasim Enar. Correlation between the AHCPR (Agency For Health Care Policy and Research) risk stratification and angiographic morphology in non-ST-segment elevation acute coronary syndrome. Turk Kardiyol Dern Ars. 2011; 39(2): 105-113

Corresponding Author: Ahmet Yıldız, Türkiye
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