Romero-Farina reported a modification of the Vall d'Hebron Risk Score for predicting risk of myocardial infarction and cardiac death. The authors are from Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, and Hospital Universitari Vall d'Hebron in Spain.
Patient selection: no history of previous myocardial infarction and/or coronary revascularization
Outcome: 4-year risk of myocardial infarction or cardiac death
Parameters:
(1) age at clinical evaluation in years
(2) diabetes
(3) METs during exercise testing
(4) ST segment depression in mm
(5) left ventricular ejection fraction (LVEF) in percent
(6) summed stress score (SSS, SPECT stress-risk)
|
Parameter
|
Finding
|
Points
|
|
age at clinical evaluation
|
|
0.060261 * (age)
|
|
diabetes
|
no
|
0
|
|
|
yes
|
1.029161
|
|
METs
|
|
-0.032996 * (METs)
|
|
ST segment depression
|
|
0.436628 * (ST depress)
|
|
LVEF
|
|
-0.016993 * (LVEF)
|
|
summed stress score
|
|
0.197207 * (SSS)
|
prognostic index =
= SUM(points for all of the parameters) - 8.470211
probability of AMI or cardiac death at 4 years =
= 1 / ( 1+ EXP((-1)* (prognostic index)))
Performance:
• The area under the ROC curve is 0.80.
