# HFA-ICOS BCR-ABL TKI baseline CV risk

HFA-ICOS BCR-ABL TKI baseline CV risk

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/hfa_icos_bcr_abl`
HTML: https://magentlab.com/docs/hfa-icos-bcr-abl
Markdown: https://magentlab.com/docs/hfa-icos-bcr-abl.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Classify published HFA-ICOS baseline cardiovascular risk before second- or third-generation multi-targeted kinase inhibitors for CML targeting BCR-ABL.

## When to use

When an agent needs the Lyon 2020 BCR-ABL TKI risk class and must not invent a 10-year CVD equation or a hold/monitor order.

## When not to use

- Not a medical device. Not a treatment, hold, dose, or monitoring order. Classes follow Lyon 2020 (low = no factor or one Medium 1; medium = 2–4 medium points; high = any high factor or ≥5 medium points; very high = any very-high factor).
- magent does not compute a 10-year CVD risk equation. Caller assigns cvd_10y_risk_gt_20 for the paper row Cardiovascular disease 10-year risk score >20%.
- magent does not measure ABPI, estimate pulmonary pressure, read an ECG or echocardiogram, or take a smoking history. Those rows are caller-assigned flags.
- This BCR-ABL table has no 50–54% LVEF Medium 2 row. Age bands are mutually exclusive. Current or significant smoking is High on this table, not Medium 1.

## Formula

```
HFA-ICOS BCR-ABL TKI (Lyon 2020) = very_high if arterial_vascular_disease or arterial_thrombosis_with_tki; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low (0 or one M1); medium_points = M2*2 + M1*1 only; High: heart_failure_or_lvsd, bcr_abl_tki_mediated_lvsd, abpi_le_0_9, pulmonary_arterial_hypertension, LVEF<50, QTc>=480, caller cvd_10y_risk_gt_20, age>=75, current_or_significant_smoker; M2: venous_thromboembolism, arrhythmia, borderline QTc (men 450<=QTc<480, women 460<=QTc<480), hypertension, age 65-74; M1: diabetes, hyperlipidemia, age 60-64, ckd, family_history_thrombophilia, obesity; age bands mutually exclusive; no LVEF 50-54 row; magent does not compute 10-year CVD risk
```

## Citation

[Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society](https://doi.org/10.1002/ejhf.1920)
Lyon AR, Dent S, Stanway S, et al.
Eur J Heart Fail. 2020;22(11):1945-1960
DOI: [10.1002/ejhf.1920](https://doi.org/10.1002/ejhf.1920)

## Worked example

### Age 50, no factors

Given: `abpi_le_0_9=false, age_years=50, arrhythmia=false, arterial_thrombosis_with_tki=false, arterial_vascular_disease=false, bcr_abl_tki_mediated_lvsd=false, ckd=false, current_or_significant_smoker=false, cvd_10y_risk_gt_20=false, diabetes=false, family_history_thrombophilia=false, heart_failure_or_lvsd=false, hyperlipidemia=false, hypertension=false, lvef_percent=60, obesity=false, pulmonary_arterial_hypertension=false, qtc_ms=400, sex=female, venous_thromboembolism=false`

1. age 50 is <60 so no age points
2. LVEF 60 and QTc 400 add no points
3. all flags false including cvd_10y_risk_gt_20
4. medium_points = 0; risk_level = low; cardiotoxicity_guide = <2%


### Hypertension only

Given: `abpi_le_0_9=false, age_years=50, arrhythmia=false, arterial_thrombosis_with_tki=false, arterial_vascular_disease=false, bcr_abl_tki_mediated_lvsd=false, ckd=false, current_or_significant_smoker=false, cvd_10y_risk_gt_20=false, diabetes=false, family_history_thrombophilia=false, heart_failure_or_lvsd=false, hyperlipidemia=false, hypertension=true, lvef_percent=60, obesity=false, pulmonary_arterial_hypertension=false, qtc_ms=400, sex=female, venous_thromboembolism=false`

1. hypertension is Medium 2
2. medium_points = 2; risk_level = medium; cardiotoxicity_guide = 2-9%


### Current or significant smoker

Given: `abpi_le_0_9=false, age_years=50, arrhythmia=false, arterial_thrombosis_with_tki=false, arterial_vascular_disease=false, bcr_abl_tki_mediated_lvsd=false, ckd=false, current_or_significant_smoker=true, cvd_10y_risk_gt_20=false, diabetes=false, family_history_thrombophilia=false, heart_failure_or_lvsd=false, hyperlipidemia=false, hypertension=false, lvef_percent=60, obesity=false, pulmonary_arterial_hypertension=false, qtc_ms=400, sex=female, venous_thromboembolism=false`

1. smoking is High on this table
2. medium_points = 0; risk_level = high; cardiotoxicity_guide = 10-19%


### Arterial vascular disease

Given: `abpi_le_0_9=false, age_years=50, arrhythmia=false, arterial_thrombosis_with_tki=false, arterial_vascular_disease=true, bcr_abl_tki_mediated_lvsd=false, ckd=false, current_or_significant_smoker=false, cvd_10y_risk_gt_20=false, diabetes=false, family_history_thrombophilia=false, heart_failure_or_lvsd=false, hyperlipidemia=false, hypertension=false, lvef_percent=60, obesity=false, pulmonary_arterial_hypertension=false, qtc_ms=400, sex=female, venous_thromboembolism=false`

1. arterial_vascular_disease is Very high
2. risk_level = very_high; cardiotoxicity_guide = >=20%


## Also searched as

- HFA-ICOS BCR-ABL
- BCR-ABL TKI cardiovascular risk
- HFA ICOS CML kinase inhibitor
- cardio-oncology BCR-ABL baseline
- Lyon 2020 BCR-ABL TKI

## Parameters

- `age_years` (integer, required): Age in years (integer 18-100). Lyon 2020 BCR-ABL table: ≥75 High; 65-74 Medium 2; 60-64 Medium 1 (paper row Age ≥60 years under the higher bands); <60 none. Bands do not stack. magent does not examine the patient.
- `sex` (string, required): Sex male or female. Selects the borderline QTc Medium 2 window (men 450≤QTc<480; women 460≤QTc<480). magent does not read an ECG.
- `lvef_percent` (number, required): Left-ventricular ejection fraction in percent (10-80). <50 is High. This table has no 50-54 Medium 2 LVEF row; ≥50 adds no LVEF points. magent does not read an echocardiogram.
- `qtc_ms` (number, required): QTc in milliseconds (300-700). ≥480 is High. Borderline Medium 2 is men 450≤QTc<480 and women 460≤QTc<480. magent does not measure QTc.
- `arterial_vascular_disease` (boolean, required): Caller-assigned arterial vascular disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). Very high. magent does not diagnose vascular disease.
- `arterial_thrombosis_with_tki` (boolean, required): Caller-assigned arterial thrombosis associated with a BCR-ABL TKI. Very high. magent does not diagnose thrombosis.
- `heart_failure_or_lvsd` (boolean, required): Caller-assigned heart failure or left-ventricular systolic dysfunction. High. magent does not diagnose heart failure.
- `bcr_abl_tki_mediated_lvsd` (boolean, required): Caller-assigned BCR-ABL TKI-mediated LVSD. High. magent does not attribute LVSD to a TKI.
- `abpi_le_0_9` (boolean, required): Caller-assigned abnormal ankle-brachial pressure index (paper: ABPI ≤0.9). High. magent does not measure ABPI.
- `pulmonary_arterial_hypertension` (boolean, required): Caller-assigned pulmonary arterial hypertension (paper: peak systolic PAP ≥35 mmHg when estimated on echocardiography). High. magent does not estimate pulmonary pressure.
- `cvd_10y_risk_gt_20` (boolean, required): Caller-assigned paper row Cardiovascular disease 10-year risk score >20%. High. magent does not compute SCORE2, PCE, or any other 10-year CVD equation.
- `current_or_significant_smoker` (boolean, required): Caller-assigned current smoker or significant smoking history. High on this BCR-ABL table (not Medium 1). magent does not take a smoking history.
- `venous_thromboembolism` (boolean, required): Caller-assigned venous thromboembolism (DVT or PE). Medium 2. magent does not diagnose VTE.
- `arrhythmia` (boolean, required): Caller-assigned arrhythmia (paper: atrial fibrillation, atrial flutter, ventricular tachycardia, or ventricular fibrillation). Medium 2. magent does not read a rhythm strip.
- `hypertension` (boolean, required): Caller-assigned hypertension (paper: SBP >140 mmHg or DBP >90 mmHg, or on treatment). Medium 2. magent does not measure blood pressure.
- `diabetes` (boolean, required): Caller-assigned diabetes (paper: HbA1c >7.0% or >53 mmol/mol, or on treatment). Medium 1. magent does not diagnose diabetes.
- `hyperlipidemia` (boolean, required): Caller-assigned hyperlipidemia (paper: non-HDL cholesterol >3.8 mmol/L or >145 mg/dL). Medium 1. magent does not assay lipids.
- `ckd` (boolean, required): Caller-assigned chronic kidney disease (paper: eGFR <60 mL/min/1.73 m²). Medium 1. magent does not compute eGFR.
- `family_history_thrombophilia` (boolean, required): Caller-assigned family history of thrombophilia. Medium 1. magent does not take a family history.
- `obesity` (boolean, required): Caller-assigned obesity (paper: BMI >30 kg/m²). Medium 1. magent does not compute BMI.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/hfa_icos_bcr_abl`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "abpi_le_0_9": "false",
      "age_years": "50",
      "arrhythmia": "false",
      "arterial_thrombosis_with_tki": "false",
      "arterial_vascular_disease": "false",
      "bcr_abl_tki_mediated_lvsd": "false",
      "ckd": "false",
      "current_or_significant_smoker": "false",
      "cvd_10y_risk_gt_20": "false",
      "diabetes": "false",
      "family_history_thrombophilia": "false",
      "heart_failure_or_lvsd": "false",
      "hyperlipidemia": "false",
      "hypertension": "false",
      "lvef_percent": "60",
      "obesity": "false",
      "pulmonary_arterial_hypertension": "false",
      "qtc_ms": "400",
      "sex": "female",
      "venous_thromboembolism": "false"
    },
    {
      "abpi_le_0_9": "false",
      "age_years": "50",
      "arrhythmia": "false",
      "arterial_thrombosis_with_tki": "false",
      "arterial_vascular_disease": "false",
      "bcr_abl_tki_mediated_lvsd": "false",
      "ckd": "false",
      "current_or_significant_smoker": "false",
      "cvd_10y_risk_gt_20": "false",
      "diabetes": "false",
      "family_history_thrombophilia": "false",
      "heart_failure_or_lvsd": "false",
      "hyperlipidemia": "false",
      "hypertension": "false",
      "lvef_percent": "60",
      "obesity": "false",
      "pulmonary_arterial_hypertension": "false",
      "qtc_ms": "400",
      "sex": "female",
      "venous_thromboembolism": "false"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/hfa-icos-bcr-abl

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/hfa_icos_bcr_abl",
  "items": [
    {
      "components": [
        {
          "factor": "arterial_vascular_disease",
          "points": 0,
          "present": false
        },
        {
          "factor": "arterial_thrombosis_with_tki",
          "points": 0,
          "present": false
        },
        {
          "factor": "heart_failure_or_lvsd",
          "points": 0,
          "present": false
        },
        {
          "factor": "bcr_abl_tki_mediated_lvsd",
          "points": 0,
          "present": false
        },
        {
          "factor": "abpi_le_0_9",
          "points": 0,
          "present": false
        },
        {
          "factor": "pulmonary_arterial_hypertension",
          "points": 0,
          "present": false
        },
        {
          "factor": "lvef_lt_50",
          "points": 0,
          "present": false
        },
        {
          "factor": "qtc_ge_480",
          "points": 0,
          "present": false
        },
        {
          "factor": "cvd_10y_risk_gt_20",
          "points": 0,
          "present": false
        },
        {
          "factor": "age_ge_75",
          "points": 0,
          "present": false
        },
        {
          "factor": "current_or_significant_smoker",
          "points": 0,
          "present": false
        },
        {
          "factor": "venous_thromboembolism",
          "points": 0,
          "present": false
        },
        {
          "factor": "arrhythmia",
          "points": 0,
          "present": false
        },
        {
          "factor": "borderline_qtc",
          "points": 0,
          "present": false
        },
        {
          "factor": "hypertension",
          "points": 0,
          "present": false
        },
        {
          "factor": "age_65_74",
          "points": 0,
          "present": false
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false
        },
        {
          "factor": "hyperlipidemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "age_60_64",
          "points": 0,
          "present": false
        },
        {
          "factor": "ckd",
          "points": 0,
          "present": false
        },
        {
          "factor": "family_history_thrombophilia",
          "points": 0,
          "present": false
        },
        {
          "factor": "obesity",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Lyon AR, Dent S, Stanway S, et al.",
        "doi": "10.1002/ejhf.1920",
        "id": "lyon-2020",
        "pmid": "32458582",
        "source": "Eur J Heart Fail. 2020;22(11):1945-1960",
        "title": "Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society"
      },
      "formula": "hfa_icos_bcr_abl",
      "formula_expression": "HFA-ICOS BCR-ABL TKI (Lyon 2020) = very_high if arterial_vascular_disease or arterial_thrombosis_with_tki; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low (0 or one M1); medium_points = M2*2 + M1*1 only; High: heart_failure_or_lvsd, bcr_abl_tki_mediated_lvsd, abpi_le_0_9, pulmonary_arterial_hypertension, LVEF<50, QTc>=480, caller cvd_10y_risk_gt_20, age>=75, current_or_significant_smoker; M2: venous_thromboembolism, arrhythmia, borderline QTc (men 450<=QTc<480, women 460<=QTc<480), hypertension, age 65-74; M1: diabetes, hyperlipidemia, age 60-64, ckd, family_history_thrombophilia, obesity; age bands mutually exclusive; no LVEF 50-54 row; magent does not compute 10-year CVD risk",
      "age_years": 50,
      "sex": "female",
      "qtc_ms": 400.0,
      "cardiotoxicity_guide": "<2%",
      "lvef_percent": 60.0,
      "medium_points": 0,
      "risk_level": "low"
    },
    {
      "components": [
        {
          "factor": "arterial_vascular_disease",
          "points": 0,
          "present": false
        },
        {
          "factor": "arterial_thrombosis_with_tki",
          "points": 0,
          "present": false
        },
        {
          "factor": "heart_failure_or_lvsd",
          "points": 0,
          "present": false
        },
        {
          "factor": "bcr_abl_tki_mediated_lvsd",
          "points": 0,
          "present": false
        },
        {
          "factor": "abpi_le_0_9",
          "points": 0,
          "present": false
        },
        {
          "factor": "pulmonary_arterial_hypertension",
          "points": 0,
          "present": false
        },
        {
          "factor": "lvef_lt_50",
          "points": 0,
          "present": false
        },
        {
          "factor": "qtc_ge_480",
          "points": 0,
          "present": false
        },
        {
          "factor": "cvd_10y_risk_gt_20",
          "points": 0,
          "present": false
        },
        {
          "factor": "age_ge_75",
          "points": 0,
          "present": false
        },
        {
          "factor": "current_or_significant_smoker",
          "points": 0,
          "present": false
        },
        {
          "factor": "venous_thromboembolism",
          "points": 0,
          "present": false
        },
        {
          "factor": "arrhythmia",
          "points": 0,
          "present": false
        },
        {
          "factor": "borderline_qtc",
          "points": 0,
          "present": false
        },
        {
          "factor": "hypertension",
          "points": 0,
          "present": false
        },
        {
          "factor": "age_65_74",
          "points": 0,
          "present": false
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false
        },
        {
          "factor": "hyperlipidemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "age_60_64",
          "points": 0,
          "present": false
        },
        {
          "factor": "ckd",
          "points": 0,
          "present": false
        },
        {
          "factor": "family_history_thrombophilia",
          "points": 0,
          "present": false
        },
        {
          "factor": "obesity",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Lyon AR, Dent S, Stanway S, et al.",
        "doi": "10.1002/ejhf.1920",
        "id": "lyon-2020",
        "pmid": "32458582",
        "source": "Eur J Heart Fail. 2020;22(11):1945-1960",
        "title": "Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society"
      },
      "formula": "hfa_icos_bcr_abl",
      "formula_expression": "HFA-ICOS BCR-ABL TKI (Lyon 2020) = very_high if arterial_vascular_disease or arterial_thrombosis_with_tki; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low (0 or one M1); medium_points = M2*2 + M1*1 only; High: heart_failure_or_lvsd, bcr_abl_tki_mediated_lvsd, abpi_le_0_9, pulmonary_arterial_hypertension, LVEF<50, QTc>=480, caller cvd_10y_risk_gt_20, age>=75, current_or_significant_smoker; M2: venous_thromboembolism, arrhythmia, borderline QTc (men 450<=QTc<480, women 460<=QTc<480), hypertension, age 65-74; M1: diabetes, hyperlipidemia, age 60-64, ckd, family_history_thrombophilia, obesity; age bands mutually exclusive; no LVEF 50-54 row; magent does not compute 10-year CVD risk",
      "age_years": 50,
      "sex": "female",
      "qtc_ms": 400.0,
      "cardiotoxicity_guide": "<2%",
      "lvef_percent": 60.0,
      "medium_points": 0,
      "risk_level": "low"
    }
  ]
}
```

## Response fields

- `formula` (string): hfa_icos_bcr_abl
- `formula_expression` (string): Exact expression used
- `age_years` (integer): Age in years used
- `sex` (string): male or female used for the QTc window
- `lvef_percent` (number): LVEF percent used
- `qtc_ms` (number): QTc in milliseconds used
- `medium_points` (integer): Sum of Medium 1 (1 each) and Medium 2 (2 each) only
- `risk_level` (string): very_high, high, medium, or low from the Lyon 2020 BCR-ABL table. A class, not a treatment order.
- `cardiotoxicity_guide` (string): Lyon 2020 expert-opinion future-cardiotoxicity guide: <2% / 2-9% / 10-19% / >=20%
- `components` (array): Per-factor presence and medium points
- `citation` (object): Lyon et al. Eur J Heart Fail 2020 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "factor": "arterial_vascular_disease",
      "points": 0,
      "present": false
    },
    {
      "factor": "arterial_thrombosis_with_tki",
      "points": 0,
      "present": false
    },
    {
      "factor": "heart_failure_or_lvsd",
      "points": 0,
      "present": false
    },
    {
      "factor": "bcr_abl_tki_mediated_lvsd",
      "points": 0,
      "present": false
    },
    {
      "factor": "abpi_le_0_9",
      "points": 0,
      "present": false
    },
    {
      "factor": "pulmonary_arterial_hypertension",
      "points": 0,
      "present": false
    },
    {
      "factor": "lvef_lt_50",
      "points": 0,
      "present": false
    },
    {
      "factor": "qtc_ge_480",
      "points": 0,
      "present": false
    },
    {
      "factor": "cvd_10y_risk_gt_20",
      "points": 0,
      "present": false
    },
    {
      "factor": "age_ge_75",
      "points": 0,
      "present": false
    },
    {
      "factor": "current_or_significant_smoker",
      "points": 0,
      "present": false
    },
    {
      "factor": "venous_thromboembolism",
      "points": 0,
      "present": false
    },
    {
      "factor": "arrhythmia",
      "points": 0,
      "present": false
    },
    {
      "factor": "borderline_qtc",
      "points": 0,
      "present": false
    },
    {
      "factor": "hypertension",
      "points": 0,
      "present": false
    },
    {
      "factor": "age_65_74",
      "points": 0,
      "present": false
    },
    {
      "factor": "diabetes",
      "points": 0,
      "present": false
    },
    {
      "factor": "hyperlipidemia",
      "points": 0,
      "present": false
    },
    {
      "factor": "age_60_64",
      "points": 0,
      "present": false
    },
    {
      "factor": "ckd",
      "points": 0,
      "present": false
    },
    {
      "factor": "family_history_thrombophilia",
      "points": 0,
      "present": false
    },
    {
      "factor": "obesity",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Lyon AR, Dent S, Stanway S, et al.",
    "doi": "10.1002/ejhf.1920",
    "id": "lyon-2020",
    "pmid": "32458582",
    "source": "Eur J Heart Fail. 2020;22(11):1945-1960",
    "title": "Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society"
  },
  "formula": "hfa_icos_bcr_abl",
  "formula_expression": "HFA-ICOS BCR-ABL TKI (Lyon 2020) = very_high if arterial_vascular_disease or arterial_thrombosis_with_tki; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low (0 or one M1); medium_points = M2*2 + M1*1 only; High: heart_failure_or_lvsd, bcr_abl_tki_mediated_lvsd, abpi_le_0_9, pulmonary_arterial_hypertension, LVEF<50, QTc>=480, caller cvd_10y_risk_gt_20, age>=75, current_or_significant_smoker; M2: venous_thromboembolism, arrhythmia, borderline QTc (men 450<=QTc<480, women 460<=QTc<480), hypertension, age 65-74; M1: diabetes, hyperlipidemia, age 60-64, ckd, family_history_thrombophilia, obesity; age bands mutually exclusive; no LVEF 50-54 row; magent does not compute 10-year CVD risk",
  "age_years": 50,
  "sex": "female",
  "qtc_ms": 400.0,
  "cardiotoxicity_guide": "<2%",
  "lvef_percent": 60.0,
  "medium_points": 0,
  "risk_level": "low"
}
```

## Errors

- HTTP 400 `invalid_hfa_icos_bcr_abl`: Lyon 2020 HFA-ICOS BCR-ABL TKI inputs must match that table's age, LVEF, QTc, sex, caller-assigned 10-year CVD threshold, and yes/no factors. Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [HFA-ICOS anthracycline baseline CV risk](https://magentlab.com/docs/hfa-icos-anthracycline) — Apply the Lyon 2020 HFA-ICOS anthracycline baseline cardiovascular risk proforma from caller-assigned age, LVEF, and published Very high, High, Medium 2, and Medium 1 factors. Returns risk_level, medium_points, and the paper's expert-opinion cardiotoxicity_guide.
- [NYHA](https://magentlab.com/docs/nyha) — Return the 1994 NYHA functional capacity class 1-4 from a caller-assigned integer, with the published class description.
- [MAGGIC](https://magentlab.com/docs/maggic) — Sum the Pocock 2013 MAGGIC integer chart from thirteen caller-supplied heart-failure predictors and return the published Table 4 1-year and 3-year death probabilities for scores 0-50.
- [HCM Risk-SCD](https://magentlab.com/docs/hcm-risk-scd) — Compute the O'Mahony 2014 HCM Risk-SCD 5-year sudden cardiac death probability from maximal wall thickness, left-atrial diameter, maximal LVOT gradient, family history of SCD, NSVT, unexplained syncope, and age.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.