Validation of the Agency for Health Care Policy and Research (AHCPR) classification for managing unstable angina

To validate the AHCPR classification for thr prognosis of unstable angina, 225 consecutive patients were recruited with a suspected diagnosis of that condition attending a tertiary hospital from November 1994 through April 19 95 and followed for one year. One-hundred fifty-six (69.3%) patients were c onsidered at high risk, 37 (16.5%) at intermediate, and 32 (14.2%) at low r isk of cardiac complications. All of the patients with major in-hospital ca rdiac complications (8 patients) had at least one of the features of the hi gh risk group. The high to intermediate-low hazard ratio (HR) for one-year cardiac complications after the onset of unstable angina was 4.03. Predicto rs of major complications (myocardial infarction or death) after the follow -up were age > 65 (HR, 5.69); diabetes (HR, 4.94); heart failure (HR, 2.65) ; and prolonged angina (HR, 2.55). AHCPR classification correctly identifie d patients with risk of severe outcomes at the hospital. Also, the classifi cation predicted outcomes one year after hospitalization, diabetes being an important determinant of adverse cardiac events. (C) 1999 Elsevier Science Inc.