title: Correlation between the AHCPR (Agency For Health Care Policy and Research) risk stratification and angiographic morphology in non-ST-segment elevation acute coronary syndrome.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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 <III (p=0.02) were associated with high risk in multivariate analyses.
  
  
  CONCLUSIONS
  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.
authors: Department of Cardiology, Cardiology Institute, İstanbul University, İstanbul, Turkey. drayildiz@yahoo.com
authors: Ahmet
authors: A
authors: Yıldız
authors: Seçkin
authors: S
authors: Pehlivanoğlu
authors: Tevfik
authors: T
authors: Gürmen
authors: Uğur
authors: U
authors: Coşkun
authors: Kadriye Orta
authors: KO
authors: Kılıçkesmez
authors: Murat
authors: M
authors: Başkurt
authors: Cem
authors: C
authors: Bostan
authors: Alev
authors: A
authors: Arat-Özkan
authors: Barış
authors: B
authors: Okçün
authors: Rasim
authors: R
authors: Enar
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D000368:Aged; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors