The INTERHEART Modifiable Risk Score (IHMRS) can help to identify patients at risk for myocardial infarction. The risk of infarction may be reduced by modifying risk factors. The study is based on the INTERHEART study which was performed at universities around the world.
Parameters:
(1) age and gender
(2) ratio of apolipoprotein B to A1
(3) smoking history in past 12 months
(4) second hand smoke
(5) diabetes mellitus
(6) high blood pressure
Parameter
Finding
Points
age and gender
male and >= 55 years of age
2
female and >= 65 years of age
2
other
0
ratio of apolipoproteins
< 0.633
0
0.633 to 0.792
2
0.793 to 0.983
3
>= 0.984
7
smoking history
never
0
quit more than 12 months ago
2
1 to 5 cigarettes per day
2
6 to 10 per day
4
11 to 15 per day
6
16 to 20 per day
7
> 20 per day
10
second hand smoke
none or < 1 hour per week
0
>= 1 hour per week
2
diabetes
no
0
yes
6
hypertension
no
0
yes
5
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 32
• The higher the score the greater the risk of myocardial infarction.
Score
Odds Ratio
1 Year Risk AMI
<= 4
1
0.04%
5 to 9
2
0.09%
>= 10
6
0.68%
Performance:
• A score >= 5 had a sensitivity of 78% and specificity of 50% for AMI.
• The area under the ROC curve was 0.71.
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