Abstract 313

Appropriate use criteria (AUC) have been developed for guiding clinical decision-making for coronary revascularization (revasc). We studied a prospective cohort of 693 pts initiated in 1992 and managed with optimal medical therapy (OMT). AUC scores could be calculated using noninvasive test results and coronary angiographic data in 230 pts, which constitute the study group. When non-invasive findings were discordant, patients were put in the higher risk stratum. Revasc status and myocardial infarction (MI) events were ascertained as of June 2005. Mortality status was ascertained as of December 31, 2008. Based on AUC scores, pts were classified as Appropriate (A), Inappropriate (I), or Uncertain (U) for revasc. Decisions to pursue invasive evaluation and revasc were based solely on stability of symptoms, LV function, and exercise duration. Survival analysis and stepwise Cox modeling was used to assess AUC class as a predictor of outcomes.