Kaolawanich et al reported a simple clinical risk assessment tool for identifying a high coronary artery calcium score in a symptomatic patient. This can help to screen patients prior to measuring the coronary artery calcium score. The authors are from Mahidol University in Thailand.
H2VK-65 is an acronym for hypertension, heart failure, vascular disease, kidney disease and age greater than 65 years.
Outcome: high coronary artery calcium score (> 400 by Agatston method)
Parameters:
(1) hypertension
(2) heart failure
(3) vascular disease
(4) chronic kidney disease (CKD)
(5) age
Parameter
Finding
Points
hypertension
absent
0
present
3
heart failure
absent
0
present
2
vascular disease
absent
0
present
3
chronic kidney disease
absent
0
present
2
age
<= 65 years
0
> 65 years
1
total score =
=SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
• No patient <= 1 had a high coronary artery calcium score.
• A score >= 4 is associated with a high risk of a high coronary artery calcium score.
Performance:
• A score >= 4 has an area under the ROC curve of 0.88 in the derivation and 0.85 in the validation cohorts.
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