Cardiology · Haematology
HFA-ICOS Baseline Risk before CML Multi-Targeted Kinase Inhibitors calculator
Enter the published formula inputs below to calculate and interpret this score.
Clinical inputs
Allowed range: 0–2 ratio
An index of 0.9 or lower is a high-risk factor. A value of 0.91 is not.
Allowed range: 0–150 mmHg
35 mmHg or higher is high risk. A value of 34.9 is not.
Allowed range: 200–800 ms
480 ms or higher is high risk. From 450 ms in men, or from 460 ms in women, up to 479 ms is a medium-2 factor.
Allowed range: 0–100 %
A 10-year risk above 20% is high risk. A value of 20% is not.
Allowed range: 19.33–580.05 mg/dL
Above 3.8 mmol/L is a medium-1 factor. Milligrams per decilitre convert by dividing by 38.67.
Allowed range: 18–110 years
Age 75 or older is high risk. Age 65 through 74 is a medium-2 factor. Age 60 through 64 is a medium-1 factor. Under 60, age adds nothing.
Allowed range: 5–80 %
Ejection fraction under 50% is high risk. A value of 50% does not score on this table.
Allowed range: 60–260 mmHg
Systolic pressure above 140 mmHg or diastolic pressure above 90 mmHg counts as hypertension. Values of 140 and 90 do not.
Allowed range: 30–160 mmHg
Systolic pressure above 140 mmHg or diastolic pressure above 90 mmHg counts as hypertension. Values of 140 and 90 do not.
Allowed range: 4–20 %
Hemoglobin A1c above 7.0% counts as diabetes. A value of 7.0% does not.
Allowed range: 1–200 mL/min/1.73 m²
Estimated glomerular filtration rate under 60 is a medium-1 factor. A value of 60 is not.
Allowed range: 10–80 kg/m²
Body mass index above 30 kg/m² is a medium-1 factor. A value of 30 is not.
Result
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Clinical inputs
- Arterial vascular disease
- Arterial thrombosis while taking a kinase inhibitor
- Heart failure or left ventricular systolic dysfunction
- Kinase-inhibitor left ventricular systolic dysfunction
- Ankle-brachial pressure index (ratio)Accepted range: 0 to 2
- Resting pulmonary artery systolic pressure (mmHg)Accepted range: 0 to 150
- Venous thromboembolism
- Atrial fibrillation, flutter, or ventricular tachyarrhythmia
- Sex
- Corrected QT interval (ms)Accepted range: 200 to 800
- Ten-year cardiovascular risk (%)Accepted range: 0 to 100
- Non-HDL cholesterol (mmol/L)Accepted range: 0.5 to 15
- Family history of thrombophilia
- Age (years)Accepted range: 18 to 110
- Left ventricular ejection fraction (%)Accepted range: 5 to 80
- Systolic blood pressure (mmHg)Accepted range: 60 to 260
- Diastolic blood pressure (mmHg)Accepted range: 30 to 160
- On treatment for hypertension
- Hemoglobin A1c (%)Accepted range: 4 to 20
- On treatment for diabetes
- Estimated glomerular filtration rate (mL/min/1.73 m²)Accepted range: 1 to 200
- Current smoking or a substantial smoking history
- Body mass index (kg/m²)Accepted range: 10 to 80
Primary source
Lyon AR et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies. Eur J Heart Fail. DOI: 10.1002/ejhf.1920. PMID: 32463967. Table 5, second- and third-generation BCR-ABL inhibitors for chronic myeloid leukaemia. Very high: arterial vascular disease, or arterial thrombosis on a tyrosine kinase inhibitor. High: heart failure or left ventricular systolic dysfunction, BCR-ABL inhibitor-mediated left ventricular systolic dysfunction, ankle-brachial index 0.9 or lower, resting pulmonary artery systolic pressure 35 mmHg or higher, LVEF under 50%, QTc 480 ms or higher, 10-year cardiovascular risk above 20%, age 75 or older, current smoking or a significant smoking history. Medium 2: venous thromboembolism, arrhythmia, QTc from 450 ms up to but not including 480 ms in men or from 460 ms in women, hypertension, age 65–74. Medium 1: diabetes, non-HDL cholesterol above 3.8 mmol/L, age 60 years or older through 74, eGFR under 60, family history of thrombophilia, BMI above 30. Age 65–74 meets both the medium-1 age row and the medium-2 age row. Hypertension, diabetes, and eGFR use the same thresholds as the anthracycline table. Low risk is no risk factor or a single medium-1 factor. Medium risk is medium factors that add to 2 to 4 points. High risk is any high-risk factor or medium factors that add to 5 or more points. Very high risk is any very high-risk factor. Medium 1 counts 1 point and medium 2 counts 2 points. A single age and a single ejection fraction contribute only the highest matching row. (2020)
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