Back to catalog

Cardiology

2018 AHA/ACC Very High-Risk ASCVD calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Acute coronary syndrome within 12 months
Myocardial infarction other than that recent acute coronary syndrome

Count a myocardial infarction only when it is not the recent acute coronary syndrome already entered.

History of ischemic stroke
Symptomatic peripheral artery disease

Claudication with an ankle-brachial index under 0.85, or previous revascularization or amputation.

years

Allowed range: 18–110 years

Quick picks

Age of 65 years or older is one high-risk condition. Age 64 is not.

Heterozygous familial hypercholesterolemia
Prior bypass or coronary stent outside the major event

Coronary bypass or percutaneous coronary intervention that is not part of a major event already counted.

Diabetes mellitus
Hypertension
mL/min/1.73 m²

Allowed range: 0–200 mL/min/1.73 m²

Quick picks

Chronic kidney disease in this table is an eGFR from 15 through 59 mL/min/1.73 m². 14.9 and 60 do not count.

Current smoking
mg/dL

Allowed range: 10–500 mg/dL

Quick picks

100 mg/dL is 2.6 mmol/L. The high-risk row also requires maximally tolerated statin therapy and ezetimibe.

On maximally tolerated statin plus ezetimibe

The LDL row counts only when the value is 100 mg/dL or higher and this treatment is present.

History of congestive heart failure

Result

14 fields remaining

Anyone can run this calculator. Sign in to save, favourite, or send the result.

Ruqelo is AI and can make mistakes. Check important information.

Clinical inputs

  • Acute coronary syndrome within 12 months
  • Myocardial infarction other than that recent acute coronary syndrome
  • History of ischemic stroke
  • Symptomatic peripheral artery disease
  • Age (years)Accepted range: 18 to 110
  • Heterozygous familial hypercholesterolemia
  • Prior bypass or coronary stent outside the major event
  • Diabetes mellitus
  • Hypertension
  • eGFR (mL/min/1.73 m²)Accepted range: 0 to 200
  • Current smoking
  • LDL cholesterol (mg/dL)Accepted range: 10 to 500
  • On maximally tolerated statin plus ezetimibe
  • History of congestive heart failure

Primary source

Grundy SM et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Circulation. DOI: 10.1161/CIR.0000000000000625. PMID: 30586774. Table 4. Very high risk is a history of multiple major ASCVD events, or one major ASCVD event and multiple high-risk conditions. Multiple means two or more. Major events: recent acute coronary syndrome within 12 months; history of myocardial infarction other than that recent acute coronary syndrome; history of ischemic stroke; symptomatic peripheral arterial disease (claudication with ankle-brachial index under 0.85, or previous revascularization or amputation). High-risk conditions: age 65 years or older; heterozygous familial hypercholesterolemia; prior coronary bypass or percutaneous coronary intervention outside the major event; diabetes; hypertension; chronic kidney disease with eGFR 15–59 mL/min/1.73 m²; current smoking; LDL cholesterol 100 mg/dL (2.6 mmol/L) or higher despite maximally tolerated statin therapy and ezetimibe; history of congestive heart failure. The result is 1 when Table 4 is met and 0 otherwise. (2019)

View source