cliot (version 1.0.0)

heart_score_mace: HEART Score for Major Cardiac Events (MACE)

Description

Calculates the HEART Score to predict the 6-week risk of Major Adverse Cardiac Events (MACE) in patients presenting with chest pain. The score uses five variables: History, ECG, Age, Risk factors, and Troponin. It stratifies patients into Low, Moderate, and High risk groups to guide disposition (discharge vs. admission).

Usage

heart_score_mace(history_suspicion, ecg_findings, age, risk_factors_count,
                 history_atherosclerosis, troponin_limit_multiplier)

Value

A list containing:

HEART_Score

The calculated total score (Range 0-10).

Risk_Category

Classification (Low 0-3, Moderate 4-6, High 7-10).

MACE_Risk_6_Weeks

Estimated risk of MACE within 6 weeks.

Recommendation

Clinical guidance based on risk category.

Arguments

history_suspicion

Numeric (0, 1, or 2). Clinical suspicion based on history. 0: Slightly suspicious. 1: Moderately suspicious. 2: Highly suspicious.

ecg_findings

Numeric (0, 1, or 2). ECG interpretation. 0: Normal. 1: Non-specific repolarization disturbance / LBBB / PM. 2: Significant ST depression.

age

Numeric. Patient age in years. <45: 0 pts. 45-64: 1 pt. >=65: 2 pts.

risk_factors_count

Numeric. Count of cardiovascular risk factors (HTN, Hyperlipidemia, Diabetes, Family Hx, Smoking, Obesity).

history_atherosclerosis

Numeric (0 or 1). History of atherosclerotic disease (e.g., prior MI, PCI, CABG, CVA/TIA, or PAD). (1 = Yes). Note: If Risk Factors count >= 3 OR History is Yes -> 2 points. If Risk Factors 1-2 -> 1 point.

troponin_limit_multiplier

Numeric. Patient's initial troponin level divided by the normal limit (e.g., if limit is 0.04 and patient is 0.06, input 1.5). <=1x: 0 pts. 1-2x: 1 pt. >2x: 2 pts.

References

Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191-196. Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158. doi:10.1016/j.ijcard.2013.01.255

Examples

# Example 1: Low Risk
# Slight suspicion (0), Normal ECG (0), 40yo (0), 1 Risk Factor (1), Normal Trop (0.5x)
# Score = 1
heart_score_mace(0, 0, 40, 1, 0, 0.5)

# Example 2: High Risk
# Highly suspicious (2), ST depression (2), 70yo (2), 3 Risk Factors (2), Trop 3x (2)
# Score = 10
heart_score_mace(2, 2, 70, 3, 0, 3.0)