McMahan et al developed a score for predicting the risk of atherosclerotic lesions in the coronary arteries of a young patient. These can help identify patients who may benefit from more aggressive management. The authors are from multiple universities in the United States belonging to the Pathobiological Determinants of Atherosclerosis in Youth Research Group.
Patient selection: ages 15 to 34
Parameters:
(1) age
(2) gender
(3) non-HDL cholesterol
(4) HDL cholesterol
(5) smoking status
(6) blood pressure
(7) body mass index (BMI) as a measure of obesity
(8) percent glycohemoglobin as indicator of persistent hyperglycemia
|
Parameter |
Finding |
Points |
|
age |
15 - 19 |
0 |
|
|
20 - 24 |
5 |
|
|
25 - 29 |
10 |
|
|
30 - 34 |
15 |
|
gender |
male |
0 |
|
|
female |
-1 |
|
non-HDL cholesterol |
< 130 mg/dL |
0 |
|
|
130 - 159 mg/dL |
2 |
|
|
160 - 189 mg/dL |
4 |
|
|
190 - 219 mg/dL |
6 |
|
|
>= 220 mg/dL |
8 |
|
HDL cholesterol |
< 40 mg/dL |
1 |
|
|
40 - 59 mg/dL |
0 |
|
|
>= 60 mg/dL |
-1 |
|
smoking |
nonsmoker |
0 |
|
|
smoker |
1 |
|
blood pressure |
normotensive |
0 |
|
|
hypertensive |
4 |
|
BMI |
> 30 kg per sq m in a male |
6 |
|
|
other |
0 |
|
percent glycohemoglobin |
< 8% |
0 |
|
|
>= 8% |
5 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 40
• The higher the score the greater the risk of atherosclerotic lesions in the coronary arteries.
The curve in Figure 1 correlates the score and the probability of atherosclerotic lesions. Note that the maximum score shown is 30, while the theoretical limit is 40. If the curve is analyzed in JMP the following equations are derived:
risk for scores from 0 to 13 =
= (0.03239 * ((score)^2)) + (0.130613 * (score)) - 0.011476
risk for scores from 13 to 30 =
= (0.098536 * ((score)^2)) - (1.143647 * (score)) + 5.0823916
Specialty: Cardiology
ICD-10: ,
