Quantitative Health Sciences

Calculator
This calculator is based on the study by Lauer MS, Pothler CE, Magid DJ Smith SS, Kattan MW. An Externally Validated Model for Predicting Long-Term Survival Exercise Stress Treadmill Testing in Patients with Suspected Coronary Artery Disease and a Normal Electrocardiogram. Annals of Internal Medicine 2007;147.

It allows for predicting mortality probabilities over the next 3, 5 and 10 years for patients with suspected coronary artery disease.

To enter the risk calculator, please click the following link.

Mortality Probability Calculator in Patients with Suspected CAD

March 2008: Version 3.0

This application needs to run on Microsoft Excel software. In order to enable the Macros in this risk calculator to work properly, you need to set the Macro security level in your Excel to be medium or lower. You can change the security setting by going to Excel menu Tool --> Macros --> Security. When you invoke Microsoft Excel, please select "Enable Macros" in the security warning window. If your security system does not allow you to set the security level to be medium or lower, please install the digital certificate of the Macros issued by Cleveland Clinic QHS, indicating that enabling Macros in this calculator is safe. This digital certificate can be installed automatically if you tick "Always trust macros from this publisher", in the security warning window.

Important notes on use of this risk calculator:
•  Typical angina: This is chest discomfort that is substernal, is brought on by physical or mental exertion, and is relieved within minutes by rest or nitroglycerin.

•  Smoking: Regular smoking now or within the past year.

•  Hypertension: Resting systolic BP >= 140 mm Hg, resting diastolic BP >= 90 mm Hg, or use of medications for treatment of hypertension.

•  Proportion of predicted METs (Metabolic equivalents) achieved: In men predicted METs is [14.7 - (0.11 X age)]; in women predicted METs is [14.7 - (0.13 X age)].

•  ST depression: Only count horizontal or downsloping ST depression that is at least 1 mm; otherwise record as 0.

•  Exercise-induced angina: Any angina is included, whether or not it is test-terminating

•  Abnormal heart rate recovery: Calculated as heart rate at the end of graded exercise minus heart rate one minute later. For upright cool down, consider abnormal if <= 12 beats/minute; for supine cool down, consider abnormal if <= 18 beats/minute.

•  Frequent ventricular ectopy in recovery: Includes at least 7 premature ventricular beats/min, frequent ventricular couplets, any ventricular triplets, nonsustained or sustained ventricular tachycardia or torsade de pointes, or ventricular fibrillation occurring in the first 5 minutes of recovery.

Disclaimer: This prediction tool is designed to help physicians and patients optimize the management of coronary artery disease under the treatment of a licensed physician. This tool is NOT a replacement for medical advice from a physician. Individual survival may vary greatly from the prediction provided by this tool.