EBMcalc Logo
   INTRO    EQUATIONS    CRITERIA    DECISION TREES    CONVERTERS    SPECIALTIES    OPTIMIZERS    REFS    SEARCH    NEW    PRESS    CONTACT
 
  Cardiovascular Risk Assessment (10-year, MESA 2015, with or without CAC score) and Optimization

 
Input
 
Race Black or African American (1)

Chinese American (2)

Hispanic (3)

Non-Hispanic white (4)
Sex Female (0)

Male (1)
Age  
Total cholesterol  
HDL cholesterol  
Systolic blood pressure  
On hypertension medication No (0)

Yes (1)
On lipid-lowering medication No (0)

Yes (1)
Diabetes No (0)

Yes (1)
Smoker No (0)

Yes (1)
Family history of MI No (0)

Yes (1)
CAC   Agatston units

 
Results
 
 
Terms  
10-year risk  
Terms CAC  
10-year risk CAC  
 
Decimal Precision  

 
   
 

 
Notes
  • Equation parameters such as Race, have two or more discrete values that may be used in the calculation. The numbers in the parentheses, e.g. (1), represent the values that will be used.
  • MESA: Multi-Ethnic Study of Atherosclerosis; CAC: coronary artery calcification; HDL: high-density lipoprotein; MI: myocardial infarction; ASCVD: atherosclerotic cardiovascular disease; CHD: coronary heart disease.
  • This calculator helps predict the 10-year risk of the following ASCVD events:
    • CHD death
    • Nonfatal MI
    • Resuscitated cardiac arrest
    • Coronary revascularization in patient with angina
  • When a CAC score is known, a second 10-year risk calculation is done using independent hazard ratios associated with CAC scores.
  • Optimization limits include: Total Cholesterol ≥100 mg/dL with a Total Cholesterol to HDL Cholesterol ratio ≥2. Systolic Blood Pressure must be ≥95 mmHg.
  • Easy optimizations include:
     
    1) Decrease total cholesterol 10%  
    2) Increase HDL cholesterol 10%  
    3) Decrease systolic blood pressure 10%
  • Medium intensity optimizations include:
     
    1) Decrease total cholesterol 20%  
    2) Increase HDL cholesterol 20%  
    3) Decrease systolic blood pressure 20%  
    4) Discontinue blood pressure medication  
    5) Quit smoking
  • Hard optimizations include:
     
    1) Decrease total cholesterol 30%  
    2) Increase HDL cholesterol 30%  
    3) Decrease systolic blood pressure 30%

 
Equations used
 
Terms = (Age * 0.0455) + (Sex * 0.7496) + ((Race == 1?1:0) * -0.2111) + ((Race == 2?1:0) * -0.5055) + ((Race == 3?1:0) * -0.19) + (Diabetes * 0.5168) + (Smoker * 0.4732) + (Totalcholesterol * 0.0053) - (HDLcholesterol * 0.0140) + (On lipid-lowering medication * 0.2473) + (Systolic blood pressure * 0.0085) + (On hypertension medication * 0.3381) + (Family history of MI * 0.4522)
10-year risk = 100 * (1 - 0.99963e(Terms))
Terms CAC = (Age * 0.0172) + (Sex * 0.4079) + ((Race == 1?1:0) * 0.0353) + ((Race == 2?1:0) * -0.3475) + ((Race == 3?1:0) * -0.0222) + (Diabetes * 0.3892) + (Smoker * 0.3717) + (Totalcholesterol * 0.0043) - (HDLcholesterol * 0.0114) + (On lipid-lowering medication * 0.1206) + (Systolic blood pressure * 0.0066) + (On hypertension medication * 0.2278) + (Family history of MI * 0.3239) + (ln(CAC + 1) * 0.2743)
10-year risk CAC = 100 * (1 - 0.99833e(Terms CAC))

 

 
References
  1. Smith DA. ACP Journal Club. In adults without CVD, the MESA score, including coronary artery calcium, predicted 10-y risk for CHD events. Ann Intern Med. 2016 Mar 15;164(6):JC35. PubMed ID: 26974735 PubMed Logo
  2. McClelland RL, Jorgensen NW, Budoff M, et al. 10-Year Coronary Heart Disease Risk Prediction Using Coronary Artery Calcium and Traditional Risk Factors: Derivation in the MESA (Multi-Ethnic Study of Atherosclerosis) With Validation in the HNR (Heinz Nixdorf Recall) Study and the DHS (Dallas Heart Study). J Am Coll Cardiol. 2015 Oct 13;66(15):1643-53. PubMed ID: 26449133 PubMed Logo

 
Associated Medical Subject Headings [MeSH]
 
         80 and over, Aged, Atherosclerosis, Calcinosis, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Ethnic Groups, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Reproducibility of Results, Risk Assessment, Risk Factors, Tomography, X-Ray Computed

 
Associated Logical Observation Identifiers Names and Codes [LOINC]
 
Parameter LOINC's and Suggested Units
Age 21612-7 : Years old      21612-7 : yr      21612-7 : years      30525-0 : Years old      30525-0 : yr      30525-0 : years      
Total Cholesterol 2093-3 : mg/dL      14647-2 : mmol/L      
HDL Cholesterol 2085-9 : mg/dL      14646-4 : mmol/L      
Systolic Blood Pressure 8480-6 : mmHg      

 
This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

 
Associated ICD10-CM Codes
 
   I25.84Coronary atherosclerosis due to calcified coronary lesion
   E78.5Hyperlipidemia, unspecified
   E78.4Other hyperlipidemia
   E78.2Mixed hyperlipidemia
   I10Essential (primary) hypertension
   I67.2Cerebral atherosclerosis

 
Associated ICD9-CM Codes
 
   434.0Cerebral thrombosis
   437.0Cerebral atherosclerosis
   401Essential hypertension
   401.1Benign hypertension
   272.2Mixed hyperlipidemia
   272.4Hyperlipidemia nec/nos
   414.0Coronary atherosclerosis
   414.4Coronary atherosclerosis

 
Legal Notices and Disclaimer

 
All information contained in and produced by the EBMcalc system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Click here for full notice and disclaimer.
 
EBMcalc is Copyright © 1998-2020 Foundation Internet    [Build 259946 v20.1]