Chahal et al developed a risk score for predicting the risk of heart failure in an adult. This can be used to evaluate a patient in a primary care setting who may benefit from a clinical intervention. The authors are from multiple hospitals in the United States and the National Heart, Lung and Blood Instittute of NIH.
Patient selection: adult 45 to 84 years, free of clinical cardiovascular disease at baseline
Outcome: 5-year risk of heart failure
Parameters:
(1) age in years
(2) gender
(3) smoking status
(4) body mass index (BMI)
(5) systolic blood pressure in mm Hg
(6) heart rate in beats per minute
(7) diabetes status
(8) NT pro-BNP in pg/mL
|
Parameter |
Finding |
Points |
|
age in years |
45 to 64 years |
0 |
|
|
55 to 64 years |
2 |
|
|
65 to 74 years |
4 |
|
|
75 to 84 years |
6 |
|
gender |
female |
0 |
|
|
male |
2 |
|
smoker |
never |
0 |
|
|
former |
0 |
|
|
current |
2 |
|
BMI |
normal |
0 |
|
|
overweight |
0 |
|
|
obese |
1 |
|
systolic blood pressure |
< 120 mm Hg |
0 |
|
|
120 to 139 mm Hg |
1 |
|
|
140 to 159 mm Hg |
2 |
|
|
>= 160 mm Hg |
2 |
|
heart rate |
< 60 |
-1 |
|
|
60 to 69 |
0 |
|
|
70 to 79 |
1 |
|
|
80 to 89 |
2 |
|
|
>= 90 |
4 |
|
diabetes |
normal |
0 |
|
|
impaired fasting glucose |
1 |
|
|
diabetes |
2 |
|
NT pro-BNP |
< 200 pg/mL |
0 |
|
|
200 to 399 |
4 |
|
|
400 to 599 |
6 |
|
|
600 to 799 |
8 |
|
|
>= 800 pg/mL |
11 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: -1
• maximum score: 30
• The higher the score the greater the risk of heart failure.
|
Total Score |
Risk Group |
5-Year Risk of CHF |
|
<= 9 |
low |
< 5% |
|
10 to 12 |
average |
5 to 10% |
|
13 or 14 |
high |
10 to 20% |
|
>= 15 |
very high |
> 20% |
Performance:
• The area under the ROC curve is 0.87.
Purpose: To evaluate an adult for risk of heart failure using the MESA score of Chahal et al.
Specialty: Cardiology
Objective: risk factors, severity, prognosis, stage
ICD-10: I70,
