Cardiology · Oncology
HFA-ICOS Baseline Risk for VEGF Inhibitors calculator
Enter the published formula inputs below to calculate and interpret this score.
Clinical inputs
Allowed range: 18–110 years
Age 75 years or older is a high-risk factor. Age 65 through 74 scores 1 point. Under 65 scores 0.
Allowed range: 10–80 %
Left ventricular ejection fraction under 50% is a high-risk factor. From 50% through 54% scores 2 points.
Allowed range: 300–700 ms
480 ms or longer is high risk. From 450 ms to under 480 ms scores 2 points in men. From 460 ms to under 480 ms scores 2 points in women.
Allowed range: 5–160 mL/min/1.73 m²
Estimated GFR under 60 mL/min/1.73 m² scores 1 point.
Allowed range: 12–70 kg/m²
Body mass index above 30 kg/m² scores 1 point. A value of 30 does not.
Result
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Clinical inputs
- Age (years)Accepted range: 18 to 110
- Sex for the QTc band
- Left ventricular ejection fraction (%)Accepted range: 10 to 80
- QTc (ms)Accepted range: 300 to 700
- Estimated GFR (mL/min/1.73 m²)Accepted range: 5 to 160
- Body mass index (kg/m²)Accepted range: 12 to 70
- Heart failure or cardiomyopathy
- Arterial vascular disease
- Venous thrombosis
- Arrhythmia
- Elevated baseline troponin
- Elevated baseline BNP or NT-proBNP
- Hypertension
- Diabetes mellitus
- Hyperlipidaemia
- Proteinuria
- Prior anthracycline
- Prior radiotherapy to the left chest or mediastinum
- Smoking
Primary source
Lyon AR et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society. Eur J Heart Fail. DOI: 10.1002/ejhf.1920. PMID: 32463967. Low risk is no risk factor or one medium-1 factor only. Medium risk is medium-risk points totalling 2 to 4. High risk is medium-risk points totalling 5 or more, or any high-risk factor. Very high risk is any very high-risk factor. The same paper gives a guide of under 2%, 2–9%, 10–19%, and 20% or higher for those four levels. The 2022 ESC cardio-oncology guideline (PMID 36017568) directs clinicians to these HFA-ICOS proformas. Table 4, VEGF inhibitors. Very high: heart failure or cardiomyopathy; arterial vascular disease (ischaemic heart disease, PCI, CABG, stable angina, TIA, stroke, or peripheral vascular disease). High: venous thrombosis, LVEF under 50%, QTc 480 ms or longer, age 75 years or older, hypertension, prior anthracycline. Medium 2: LVEF 50–54%, QTc 450 to under 480 ms in men or 460 to under 480 ms in women, arrhythmia. Medium 1: elevated troponin, elevated BNP or NT-proBNP, age 65–74 years, diabetes, hyperlipidaemia, eGFR under 60, proteinuria, prior radiotherapy to the left chest or mediastinum, current or significant smoking history, BMI above 30. (2020)
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