Synthetic data only. Never enter patient information; nothing is sent or stored. For clinicians. Not FDA cleared.

CPE-007 · synthetic case CVR-FX-19

A 31-year-old

Under 40 the 10-year estimate is not used.

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

Purpose: Under 40 the 10-year estimate is not used.

Inputs the engine received

Lipids and risk estimate

LDL-C
142 mg/dL
Total cholesterol
210 mg/dL
HDL-C
55 mg/dL

Patient

Age
31 years

Risk enhancers and extra tests

Family history of premature ASCVD
Yes

What the engine reports

Detected clinical pattern

10-Year Risk Estimate Needed

Enter a 10-year risk from a validated calculator. This engine does not calculate it.

Why this pattern was identified

  • Risk enhancers listed. family history of premature ASCVD. The guideline uses enhancers mainly in borderline and intermediate risk.

Calculations

Non-HDL cholesterol
155 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.

Differentials, pitfalls and contradicting signals

  • Under 40, lifetime risk, family history and severe hypercholesterolemia matter more than a 10-year estimate.
Evidence and rule trace · 3 rules

CV-CALC-01Derived value

Inputs: total cholesterol 210 · HDL-C 55

Non-HDL cholesterol 155 mg/dL.

CV-SCOPE-02Age bands that change the approach

Inputs: age 31

10-year risk is not estimated under 40.

CV-06Lipoprotein(a)

Inputs: Lp(a) never measured

One-time measurement is recommended by several societies.

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.

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

The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.

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

No stage is assigned for the values entered.

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

10-Year Risk Estimate Needed

Enter a 10-year risk from a validated calculator. This engine does not calculate it.

Why this pattern was identified

  • Risk enhancers listed. family history of premature ASCVD. The guideline uses enhancers mainly in borderline and intermediate risk.

Calculations

Non-HDL cholesterol
155 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.

Differentials, pitfalls and contradicting signals

  • Under 40, lifetime risk, family history and severe hypercholesterolemia matter more than a 10-year estimate.
Evidence and rule trace · 3 rules

CV-CALC-01Derived value

Inputs: total cholesterol 210 · HDL-C 55

Non-HDL cholesterol 155 mg/dL.

CV-SCOPE-02Age bands that change the approach

Inputs: age 31

10-year risk is not estimated under 40.

CV-06Lipoprotein(a)

Inputs: Lp(a) never measured

One-time measurement is recommended by several societies.

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.

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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