What question did this study set out to answer?

This study evaluates the effectiveness of the MAPH score in predicting thrombus burden in unstable angina pectoris.

March 26, 2026Konuralp Tıp Dergisi0 citationsOpen Access

The Role of the MAPH Score in Predicting Thrombus Burden in Unstable Angina Pectoris

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Unstable angina pectoris (n=320). Intervention: MAPH score vs. High-shear rate (HSR) and low-shear rate (LSR) blood viscosity. Primary outcome: High angiographic thrombus burden (TIMI ≥4) (AUC 0.552).

İAİsmail AtaşRecep Tayyip Erdoğan University MYMümin Murat YazıcıRecep Tayyip Erdoğan University AÇAhmet Nurhak Çakır

Key Result

The MAPH score and blood viscosity parameters showed limited diagnostic performance (AUC 0.552) for predicting angiographic thrombus burden in patients with unstable angina pectoris.

Key Points

This study evaluates the effectiveness of the MAPH score in predicting thrombus burden in unstable angina pectoris.
Single-center retrospective observational study
Included 320 adults diagnosed with unstable angina pectoris
Used TIMI thrombus classification to grade thrombus burden
Compared MAPH score with low-shear and high-shear viscosity
Assessed diagnostic performance with ROC analysis
High thrombus burden was found in 10.9% at TIMI ≥4 and 17.2% at TIMI ≥3
No significant differences in MAPH, LSR, and HSR between thrombus burden groups
ROC analysis showed limited discrimination for all parameters
AUC for TIMI ≥4 was 0.552 for MAPH, 0.491 for HSR, and 0.500 for LSR
AUC for TIMI ≥3 was 0.547, 0.516, and 0.519 respectively.

Study Design

Type

Observational (n=320)

Multicenter

Structured PICO

Does the MAPH score predict angiographic coronary thrombus burden in adult patients with unstable angina pectoris?

Population

Adult patients diagnosed with unstable angina pectoris (UAP) who underwent coronary angiography

Intervention

MAPH score (Mean Platelet Volume–Age–Protein–Hematocrit)

Comparator

Low-shear rate (LSR) and high-shear rate (HSR) blood viscosity parameters

Outcome

Angiographic thrombus burden graded using the TIMI thrombus classification (cut-offs ≥4 and ≥3)surrogate

The MAPH score and blood viscosity parameters (HSR, LSR) have limited diagnostic value and should not be relied upon to predict angiographic thrombus burden in patients with unstable angina pectoris.

Main Result

Effect estimate: AUC 0.552

Limitations

Single-center and retrospective design carries the risk of selection bias
Thrombus burden was assessed by angiographic TIMI classification without confirmation by OCT or IVUS
Hematologic parameters are based on single-time laboratory measurements and may not reflect dynamic changes
Absence of multivariable regression analysis
Low one-month mortality rate limited the ability to perform prognostic analyses

Abstract

Aim: Hemorheologic and viscosity-related parameters, including the Mean Platelet Volume–Age–Protein–Hematocrit (MAPH) score, have shown promising performance in predicting angiographic thrombus burden in ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI). However, their diagnostic value in unstable angina pectoris (UAP) remains unclear. This study aimed to evaluate the predictive performance of the MAPH score compared with low-shear rate (LSR) and high-shear rate (HSR) blood viscosity parameters for estimating coronary thrombus burden in UAP.Material and Methods: In this single-center retrospective observational study, 320 adult patients diagnosed with UAP who underwent coronary angiography were included. Thrombus burden was graded using the TIMI thrombus classification. Two cut-offs (TIMI ≥4 and ≥3) were analyzed separately. MAPH, LSR, and, HSR were calculated from admission laboratory values. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.Results: High thrombus burden was observed in 10.9% (TIMI ≥4) and 17.2% (TIMI ≥3) of patients. Age, diabetes mellitus, history of coronary artery disease, and troponin levels were higher in the high-thrombus-burden groups, but MAPH, LSR, and HSR values did not differ significantly between the groups. ROC analysis demonstrated limited discrimination for all parameters. For TIMI ≥4, AUC values were 0.552 for MAPH, 0.491 for HSR, and 0.500 for LSR. For TIMI ≥3, AUCs were 0.547, 0.516, and 0.519, respectively.Conclusion: In patients with UAP, MAPH, HSR, and LSR the ability to predict angiographic thrombus burden was limited.

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Cite This Study

Ataş et al. (Tue,) conducted a observational in Unstable angina pectoris (n=320). MAPH score vs. High-shear rate (HSR) and low-shear rate (LSR) blood viscosity was evaluated on High angiographic thrombus burden (TIMI ≥4) (AUC 0.552). The MAPH score and blood viscosity parameters showed limited diagnostic performance (AUC 0.552) for predicting angiographic thrombus burden in patients with unstable angina pectoris.

synapsesocial.com/papers/69c4ccc9fdc3bde44891847f https://doi.org/https://doi.org/10.18521/ktd.1871763

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