Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome

YILDIZ, Ahmet; COŞKUN, Uğur; ÖKÇÜN, Barış; BOSTAN, Cem; Arat-Özkan, Alev; ENAR, Rasim; Pehlivanoğlu, Seçkin; Kilickesmez, Kadriye; BAŞKURT, Murat; GÜRMEN, Tevfik

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 YILDIZ, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Seçkin PEHLİVANOĞLU, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Tevfik GÜRMEN, (Başkent Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Uğur COŞKUN, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Kadriye ORTA KILIÇKESMEZ, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Murat BAŞKURT, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Cem BOSTAN, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Alev ARAT ÖZKAN, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Barış ÖKÇÜN, (İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye)

Rasim ENAR (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, İstanbul, Türkiye)

Türk Kardiyoloji Derneği Arşivi

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Yıl: 2011 Cilt: 39 Sayı: 2 Sayfa Aralığı: 105 - 113 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome

Öz:

Amaç: Akut koroner sendromlu (AKS) hastalarda risk sınıflaması tedavinin seçimi açısından önemlidir. Bu çalışmada ST yükselmesiz AKS’li hastalarda Amerikan Sağlık Politikaları ve Araştırmaları Dairesi (Agency for Health Care Policy and Research-AHCPR) risk sınıflaması ile anjiyografik morfoloji arasındaki ilişki araştırıldı. Çalışma planı: Çalışmaya, ileriye dönük olarak, ST yükselmesiz AKS tanısı konan 163 hasta alındı. Tüm hastalara AHCPR risk değerlendirmesi yapıldı ve koroner anjiyografi yapıldı. AHCPR risk değerlendirme sistemine göre hastalar, düşük (n=25, ort. yaş 55±10), orta (n=55, ort. yaş 58±10) ve yüksek (n=83, ort. yaş 61±11) risk gruplarına ayrıldı. Bulgular: Gruplar arasında cinsiyet, yaş ve koroner kalp hastalığı risk faktörleri açısından anlamlı fark yoktu (p>0.05). Lezyon morfolojisi açısından yüksek riskli grubun, düşük+orta riskli grupla karşılaştırılmasında, yüksek riskli grupta kompleks lezyon (%31.9 ve %4.0, p=0.001), tam tıkanıklık (%23.2 ve %0, p=0.001) ve intrakoroner trombüs (%13 ve %2, p=0.02) sıklıkları anlamlı derecede fazla bulundu. Tek değişkenli analizde, kompleks lezyon, tam tıkanıklık, intrakoroner trombüs ve TIMI <III akım olması yüksek riskle anlamlı ilişki gösterdi. Çokdeğişikenli analizde ise, kompleks lezyon (p=0.005) ve TIMI <III akım (p=0.02) varlığı yüksek risk ile anlamlı ilişki gösterdi. Sonuç: Bulgularımız, AHCPR risk sınıflamasına göre yüksek risk grubunda değerlendirilen ST yükselmesiz AKS’li hastalarda yüksek riskli koroner morfoloji sıklığının da arttığını göstermiştir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

ST yükselmesiz akut koroner sendromlu hastalarda amerikan sağlık politikaları ve araştırmaları dairesi (ahcpr) risk sınıflaması ile anjiyografik morfoloji arasındaki ilişki

Öz:

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 <III (p=0.02) were associated with high risk in multivariate analyses. Conclusion: Our findings show that the incidence of highrisk coronary morphology is increased in NSTE-ACS patients having a high-risk profile according to the AHCPR classification.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	YILDIZ A, Pehlivanoğlu S, GÜRMEN T, COŞKUN U, Kilickesmez K, BAŞKURT M, BOSTAN C, Arat-Özkan A, ÖKÇÜN B, ENAR R (2011). Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. , 105 - 113.
Chicago	YILDIZ Ahmet,Pehlivanoğlu Seçkin,GÜRMEN Tevfik,COŞKUN Uğur,Kilickesmez Kadriye,BAŞKURT Murat,BOSTAN Cem,Arat-Özkan Alev,ÖKÇÜN Barış,ENAR Rasim Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. (2011): 105 - 113.
MLA	YILDIZ Ahmet,Pehlivanoğlu Seçkin,GÜRMEN Tevfik,COŞKUN Uğur,Kilickesmez Kadriye,BAŞKURT Murat,BOSTAN Cem,Arat-Özkan Alev,ÖKÇÜN Barış,ENAR Rasim Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. , 2011, ss.105 - 113.
AMA	YILDIZ A,Pehlivanoğlu S,GÜRMEN T,COŞKUN U,Kilickesmez K,BAŞKURT M,BOSTAN C,Arat-Özkan A,ÖKÇÜN B,ENAR R Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. . 2011; 105 - 113.
Vancouver	YILDIZ A,Pehlivanoğlu S,GÜRMEN T,COŞKUN U,Kilickesmez K,BAŞKURT M,BOSTAN C,Arat-Özkan A,ÖKÇÜN B,ENAR R Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. . 2011; 105 - 113.
IEEE	YILDIZ A,Pehlivanoğlu S,GÜRMEN T,COŞKUN U,Kilickesmez K,BAŞKURT M,BOSTAN C,Arat-Özkan A,ÖKÇÜN B,ENAR R "Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome." , ss.105 - 113, 2011.
ISNAD	YILDIZ, Ahmet vd. "Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome". (2011), 105-113.

APA	YILDIZ A, Pehlivanoğlu S, GÜRMEN T, COŞKUN U, Kilickesmez K, BAŞKURT M, BOSTAN C, Arat-Özkan A, ÖKÇÜN B, ENAR R (2011). Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. Türk Kardiyoloji Derneği Arşivi, 39(2), 105 - 113.
Chicago	YILDIZ Ahmet,Pehlivanoğlu Seçkin,GÜRMEN Tevfik,COŞKUN Uğur,Kilickesmez Kadriye,BAŞKURT Murat,BOSTAN Cem,Arat-Özkan Alev,ÖKÇÜN Barış,ENAR Rasim Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. Türk Kardiyoloji Derneği Arşivi 39, no.2 (2011): 105 - 113.
MLA	YILDIZ Ahmet,Pehlivanoğlu Seçkin,GÜRMEN Tevfik,COŞKUN Uğur,Kilickesmez Kadriye,BAŞKURT Murat,BOSTAN Cem,Arat-Özkan Alev,ÖKÇÜN Barış,ENAR Rasim Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. Türk Kardiyoloji Derneği Arşivi, vol.39, no.2, 2011, ss.105 - 113.
AMA	YILDIZ A,Pehlivanoğlu S,GÜRMEN T,COŞKUN U,Kilickesmez K,BAŞKURT M,BOSTAN C,Arat-Özkan A,ÖKÇÜN B,ENAR R Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. Türk Kardiyoloji Derneği Arşivi. 2011; 39(2): 105 - 113.
Vancouver	YILDIZ A,Pehlivanoğlu S,GÜRMEN T,COŞKUN U,Kilickesmez K,BAŞKURT M,BOSTAN C,Arat-Özkan A,ÖKÇÜN B,ENAR R Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome. Türk Kardiyoloji Derneği Arşivi. 2011; 39(2): 105 - 113.
IEEE	YILDIZ A,Pehlivanoğlu S,GÜRMEN T,COŞKUN U,Kilickesmez K,BAŞKURT M,BOSTAN C,Arat-Özkan A,ÖKÇÜN B,ENAR R "Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome." Türk Kardiyoloji Derneği Arşivi, 39, ss.105 - 113, 2011.
ISNAD	YILDIZ, Ahmet vd. "Correlation between the ahcpr (agency for health care policy and research) risk stratification and angiographic morphology in non-st-segment elevation acute coronary syndrome". Türk Kardiyoloji Derneği Arşivi 39/2 (2011), 105-113.