Synthetic data only. Never enter patient information; nothing is sent or stored. For clinicians. Not FDA cleared.For licensed clinicians. Educational demonstration on synthetic data. Never enter real patient identifiers or protected health information: everything runs in your browser and nothing is sent or stored. Clinical decision support only; not FDA cleared; physician review is required.
CPE-007 · synthetic case CVR-FX-21
An 84-year-old
Individualized decisions.
Purpose: Individualized decisions.
Inputs the engine received
Lipids and risk estimate
- LDL-C
- 118 mg/dL
- Total cholesterol
- 190 mg/dL
- HDL-C
- 50 mg/dL
Patient
- Age
- 84 years
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.
Calculations
- Non-HDL cholesterol
- 140 mg/dL
Total cholesterol minus HDL-C.
Differentials, pitfalls and contradicting signals
- From age 80 trial evidence is limited and decisions are individualized.
Evidence and rule trace · 2 rules
CV-SCOPE-02Age bands that change the approach
Inputs: age 84
Decisions are individualized from age 80.
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.
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)
○ Low · <5%
Lifestyle emphasis
○ Borderline · 5 to <7.5%
Enhancers inform the discussion
○ Intermediate · 7.5 to <20%
Statin discussion favored; CAC can help
○ 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.
Patient
Recent ACS, prior MI, ischemic stroke, symptomatic PAD.
Age ≥65, HeFH, prior revascularization, diabetes, hypertension, CKD, smoking, HF.
Risk enhancers and extra tests
Treatment and familial risk
More cardio cases
CVR-FX-01
Prior myocardial infarction, LDL-C 88 on a statin
Secondary prevention, not very high risk.
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-05
Intermediate risk 12% with enhancers
Family history and an hs-CRP of 3.4.
CVR-FX-06
Borderline risk 6.0%, no enhancers
Nothing to push the decision either way.
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