Cardiovascular Risk Calculators

Estimates in-hospital mortality for patients with Acute Coronary Syndrome.

Date of Birth (calculates age)

Age (years) Age Points:
30-39: +8
40-49: +25
50-59: +41
60-69: +58
70-79: +75
80-89: +91
≥ 90: +100 +58 pts

Heart Rate (bpm) HR Points (bpm):
50-69: +3
70-89: +9
90-109: +15
110-149: +24
150-199: +38
≥ 200: +46 +9 pts

Systolic BP (mmHg) SBP Points (mmHg):
< 80: +58
80-99: +53
100-119: +43
120-139: +34
140-159: +24
160-199: +10 +34 pts

Creatinine (mg/dL) Creatinine Points (mg/dL):
0.0-0.39: +1
0.4-0.79: +4
0.8-1.19: +7
1.2-1.59: +10
1.6-1.99: +13
2.0-3.99: +21
≥ 4.0: +28 +7 pts

Killip Class +0 pts

INo clinical signs of heart failure. IIRales, S3, elevated JVP. IIIFrank pulmonary edema. IVCardiogenic shock.

Other Factors

Cardiac Arrest at Admission (+39) ST Segment Deviation (+28) Abnormal Cardiac Enzymes (+14)

Results

Total GRACE Score:

Low Risk

(<1%)

For chest pain patients presenting to the Emergency Department.

History

Slightly suspicious (+0)Patient history is not suggestive of ACS. Moderately suspicious (+1)History has some elements suggesting ACS. Highly suspicious (+2)Classic history for ACS (e.g., substernal chest pressure radiating to arm).

ECG

Normal (+0)No significant abnormalities. Non-specific changes (+1)e.g., LBBB, LVH, repolarization changes not due to ischemia. Significant ST deviation (+2)ST depression or elevation suggestive of ischemia.

Age

< 45 years (+0) 45-64 years (+1) ≥ 65 years (+2)

Risk Factors +0 pts

No Known Risk FactorsSelect this if the patient has none of the risk factors below.

HypertensionHistory of high blood pressure. HypercholesterolemiaHistory of high cholesterol. Diabetes MellitusHistory of diabetes. Current SmokerOr quit within last 3 months. Family History of CADParent or sibling with CVD before age 65. Obesity (BMI > 30)Body Mass Index greater than 30. Known Atherosclerotic DzPrior MI, PCI/CABG, CVA/TIA, or PAD. Automatically scores +2.

Troponin

Normal limit (+0)Initial troponin is within the lab's normal range. 1-3x normal limit (+1)Troponin is elevated but less than 3 times the upper limit of normal. > 3x normal limit (+2)Troponin is significantly elevated.

Results

HEART Score:

Low Risk

(1.7% MACE)

For patients with UA/NSTEMI to risk stratify for death and ischemic events.

Age ≥ 65 years (+1)Patient is 65 years of age or older. ≥ 3 CAD risk factors (+1)CAD Risk Factors:
- Family history of CAD
- Hypertension
- Hypercholesterolemia
- Diabetes
- Current smoker Known CAD (Stenosis ≥ 50%) (+1)Prior coronary stenosis of 50% or more. Aspirin use in past 7 days (+1)Patient has taken aspirin at any dose within the last week. Severe angina (≥2 episodes in 24h) (+1)At least two episodes of resting angina in the last 24 hours. ST deviation ≥ 0.5 mm (+1)ST-segment deviation of at least 0.5mm on admission ECG. Elevated cardiac marker (+1)Initial cardiac markers (e.g., Troponin, CK-MB) are elevated.

Results

TIMI Score:

Low Risk

(4.7% risk at 14 days)

Estimates 10-year risk for a first Atherosclerotic Cardiovascular Disease event.

Age (40-79)

Systolic BP (mmHg)

Total Cholesterol (mg/dL)

HDL Cholesterol (mg/dL)

Sex

FemaleMale

Race

White / OtherAfrican American

Has Diabetes?

NoYes

Smoker?

NoYes

On HTN Treatment?

NoYes

Results

10-Year ASCVD Risk:

0.0%

Low Risk

(Lifestyle modification encouraged)