Cardiology · Oncology
HFA-ICOS Baseline Risk before RAF and MEK Inhibitors calculator
Enter the published formula inputs below to calculate and interpret this score.
Clinical inputs
Allowed range: 5–80 %
50% through 54% is medium 2. Under 50% and 55% or higher add no points on this table.
Allowed range: 18–110 years
65 years or older is medium 1. This table has no separate high-risk age row.
Allowed range: 60–260 mmHg
Hypertension, and therefore medium 2, is systolic pressure above 140 mmHg or diastolic pressure above 90 mmHg or treatment.
Allowed range: 30–160 mmHg
Hypertension, and therefore medium 2, is systolic pressure above 140 mmHg or diastolic pressure above 90 mmHg or treatment.
Allowed range: 4–20 %
Diabetes, and therefore medium 1, is HbA1c above 7.0%, the same threshold as above 53 mmol/mol, or treatment. Enter the percent.
Allowed range: 1–200 mL/min/1.73 m²
Under 60 mL/min/1.73 m² is medium 1.
Allowed range: 10–80 kg/m²
Above 30 kg/m² is medium 1. 30 kg/m² does not score.
Result
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Clinical inputs
- Heart failure or cardiomyopathy
- Myocardial infarction or coronary bypass
- Stable angina
- Severe valvular heart disease
- Left ventricular ejection fraction (%)Accepted range: 5 to 80
- Arrhythmia in the table
- Baseline troponin above the local upper limit
- Baseline BNP or NT-proBNP above the local upper limit
- Age (years)Accepted range: 18 to 110
- Systolic blood pressure (mmHg)Accepted range: 60 to 260
- Diastolic blood pressure (mmHg)Accepted range: 30 to 160
- On treatment for hypertension
- HbA1c (%)Accepted range: 4 to 20
- On treatment for diabetes
- Estimated glomerular filtration rate (mL/min/1.73 m²)Accepted range: 1 to 200
- Prior anthracycline exposure
- Prior radiotherapy to the left chest or mediastinum
- Current smoking or a significant 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 7, combination RAF and MEK inhibitors (dabrafenib plus trametinib, vemurafenib plus cobimetinib, encorafenib plus binimetinib). Very high: heart failure or cardiomyopathy. High: myocardial infarction or coronary bypass, stable angina, severe valvular heart disease, prior anthracycline. Medium 2: LVEF 50–54%, troponin above the local upper limit, BNP or NT-proBNP above the local upper limit, hypertension, prior radiotherapy to the left chest or mediastinum. Medium 1: atrial fibrillation, atrial flutter, ventricular tachycardia, or ventricular fibrillation; age 65 years or older; diabetes; eGFR under 60 mL/min/1.73 m²; current smoking or a significant smoking history; BMI above 30 kg/m². Hypertension is systolic pressure above 140 mmHg or diastolic pressure above 90 mmHg or treatment. Diabetes is HbA1c above 7.0% (above 53 mmol/mol) or treatment. Low risk is no risk factor or one medium-1 factor. Medium risk is medium factors adding to 2–4 points. High risk is any high factor or medium factors adding to 5 or more points. Very high risk is any very high factor. This table has no high-risk row for LVEF under 50% and no high-risk age row. (2020)
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