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CPE-007 · synthetic case CVR-FX-05

Intermediate risk 12% with enhancers

Family history and an hs-CRP of 3.4.

Synthetic · no real patientAuthored by Biod · reviewed by Dr. AmaralCardio engine v1.0.0

Purpose: Family history and an hs-CRP of 3.4.

Inputs the engine received

Lipids and risk estimate

LDL-C
128 mg/dL
Total cholesterol
210 mg/dL
HDL-C
48 mg/dL
10-year ASCVD risk (from your calculator)
12 %
Calculator used
Pooled Cohort

Patient

Age
56 years

Risk enhancers and extra tests

Family history of premature ASCVD
Yes
hs-CRP
3.4 mg/L

What the engine reports

Detected clinical pattern

Intermediate 10-Year Risk (7.5% to <20%)

Category from the entered Pooled Cohort Equations risk. 2 risk enhancer(s) present.

  • 10-year risk: 10-year risk 12% · intermediate

Why this pattern was identified

  • Risk enhancers. 2 present: family history of premature ASCVD; hs-CRP 3.4 mg/L (≥2, if persistent). In intermediate risk they favor a statin discussion; they inform a shared decision and do not mandate treatment.

Calculations

Non-HDL cholesterol
162 mg/dL

Total cholesterol minus HDL-C.

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Consider a one-time Lp(a) measurement.ESC/EAS 2019; listed as an enhancer by ACC/AHA 2018.
Evidence and rule trace · 5 rules

CV-CALC-01Derived value

Inputs: total cholesterol 210 · HDL-C 48

Non-HDL cholesterol 162 mg/dL.

CV-0410-year ASCVD risk category

Inputs: 10-year risk 12% (Pooled Cohort Equations)

Risk category: intermediate.

CV-05Risk enhancers present

Inputs: intermediate risk · family history of premature ASCVD · hs-CRP 3.4 mg/L (≥2, if persistent)

Risk enhancers favor a statin discussion.

CV-06Lipoprotein(a)

Inputs: Lp(a) never measured

One-time measurement is recommended by several societies.

CV-08High-sensitivity CRP

Inputs: hs-CRP 3.4 mg/L

hs-CRP is a risk enhancer that informs a shared decision.

Evidence

  • EV-ACCAHA-CHOL-2018 · Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Circulation. 2019;139(25):e1082-e1143.
  • EV-ACCAHA-PREV-2019 · Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Circulation. 2019;140(11):e596-e646.
  • EV-ESC-EAS-2019 · Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2020;41(1):111-188.
  • EV-JUPITER-2008 · Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein. N Engl J Med. 2008;359(21):2195-2207.

Physician adjudication required. Clinical decision support for physician review. This output organizes guideline categories and risk modifiers. It does not calculate a 10-year risk, select a drug or dose, or replace a shared decision with the patient. Physician adjudication is required.

Change the values

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10-year risk category (Pooled Cohort Equations)

  1. ✓ Low · <5%

    Lifestyle emphasis

  2. ✓ Borderline · 5 to <7.5%

    Enhancers inform the discussion

  3. ● Intermediate · 7.5 to <20%

    Statin discussion favored; CAC can help

  4. ○ High · ≥20%

    Statin benefit is greatest

Lipids and risk estimate
  • <100
  • 100–159
  • 160–189
  • ≥190
  • <150
  • 150–499
  • ≥500
  • ≥1000

This engine does not calculate it.

Calculator used
Patient

Recent ACS, prior MI, ischemic stroke, symptomatic PAD.

Age ≥65, HeFH, prior revascularization, diabetes, hypertension, CKD, smoking, HF.

Risk enhancers and extra tests
Lp(a) unit
Treatment and familial risk

Live result · computed in your browser

Detected clinical pattern

Intermediate 10-Year Risk (7.5% to <20%)

Category from the entered Pooled Cohort Equations risk. 2 risk enhancer(s) present.

  • 10-year risk: 10-year risk 12% · intermediate

Why this pattern was identified

  • Risk enhancers. 2 present: family history of premature ASCVD; hs-CRP 3.4 mg/L (≥2, if persistent). In intermediate risk they favor a statin discussion; they inform a shared decision and do not mandate treatment.

Calculations

Non-HDL cholesterol
162 mg/dL

Total cholesterol minus HDL-C.

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Consider a one-time Lp(a) measurement.ESC/EAS 2019; listed as an enhancer by ACC/AHA 2018.
Evidence and rule trace · 5 rules

CV-CALC-01Derived value

Inputs: total cholesterol 210 · HDL-C 48

Non-HDL cholesterol 162 mg/dL.

CV-0410-year ASCVD risk category

Inputs: 10-year risk 12% (Pooled Cohort Equations)

Risk category: intermediate.

CV-05Risk enhancers present

Inputs: intermediate risk · family history of premature ASCVD · hs-CRP 3.4 mg/L (≥2, if persistent)

Risk enhancers favor a statin discussion.

CV-06Lipoprotein(a)

Inputs: Lp(a) never measured

One-time measurement is recommended by several societies.

CV-08High-sensitivity CRP

Inputs: hs-CRP 3.4 mg/L

hs-CRP is a risk enhancer that informs a shared decision.

Evidence

  • EV-ACCAHA-CHOL-2018 · Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Circulation. 2019;139(25):e1082-e1143.
  • EV-ACCAHA-PREV-2019 · Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Circulation. 2019;140(11):e596-e646.
  • EV-ESC-EAS-2019 · Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2020;41(1):111-188.
  • EV-JUPITER-2008 · Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein. N Engl J Med. 2008;359(21):2195-2207.

Physician adjudication required. Clinical decision support for physician review. This output organizes guideline categories and risk modifiers. It does not calculate a 10-year risk, select a drug or dose, or replace a shared decision with the patient. Physician adjudication is required.

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CVR-FX-01

Prior myocardial infarction, LDL-C 88 on a statin

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CVR-FX-02

Very high risk with LDL-C 62 on maximal therapy

Two events: the threshold is 55.

CVR-FX-03

LDL-C 205 and tendon xanthomas

Severe hypercholesterolemia.

CVR-FX-04

Diabetes at 58 with LDL-C 110

A guideline statin group.

CVR-FX-06

Borderline risk 6.0%, no enhancers

Nothing to push the decision either way.

CVR-FX-07

Low risk 2.1%

A 45-year-old with a normal profile.

All cardio cases

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