Storti et al reported a modified Hubbard score for predicting severe coronary artery disease in a patient based on simple clinical parameters. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Instituto do Coracao, HCFMUSP in Sao Paulo.
Outcome: multi-arterial stable coronary artery disease, with cardiovascular death, myocardial infarction, re-intervention
Parameters from the Hubbard score:
(1) sex
(2) history of myocardial infarction and/or Q waves
(3) typical symptoms of angina pectoris
(4) diabetes mellitus
(5) age in years
|
Parameter
|
Finding
|
Points
|
|
sex
|
female
|
0
|
|
|
male
|
1
|
|
history of MI
|
no
|
0
|
|
|
yes
|
1
|
|
typical symptoms of angina pectoris
|
no
|
0
|
|
|
yes
|
1
|
|
diabetes
|
no
|
0
|
|
|
non-insulin-dependent
|
1
|
|
|
insulin-dependent
|
2
|
|
age
|
< 40 years
|
0
|
|
|
40 to 49 years
|
1
|
|
|
50 to 59 years
|
2
|
|
|
60 to 69 years
|
3
|
|
|
70 to 79 years
|
4
|
|
|
>= 80 years
|
5
|
Additional parameter:
(6) stress test
Positive stress test:
(1) ST segment depression >= 1 mm, horizontal or downward morphology during or after exercise, and the magnitude of the gap is measured at 80 ms from the J point
(2) ST segment elevation >= 1.0 mm in leads without pathologic Q waves
|
Parameter
|
Finding
|
Points
|
|
stress test
|
negative
|
0
|
|
|
positive
|
1
|
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
• The higher the score the greater the risk for severe coronary artery disease (CAD).
• A score >= 6 was associated with an increased risk for an adverse outcome.
