MAGENT

Hemodynamics · LIVE

HFA-ICOS HER2-targeted therapy baseline CV risk

HFA-ICOS HER2

Classify Lyon 2020 HFA-ICOS baseline cardiovascular risk before HER2-targeted therapy and return low, medium, high, or very high with the expert-opinion cardiotoxicity guide.

LIVE $0.005 USDC GET /api/calc/hfa_icos_her2

Markdown: /docs/hfa-icos-her2.md · Canonical: https://magentlab.com/docs/hfa-icos-her2

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

What it computes

Classify Lyon 2020 HFA-ICOS baseline cardiovascular risk before HER2-targeted therapy and return low, medium, high, or very high with the expert-opinion cardiotoxicity guide.

When to use

When an agent already has age, LVEF, and the published HER2-table factors as assigned by the caller and needs the HFA-ICOS class. Not a treatment, hold, or monitoring order.

When not to use

  • Not a medical device.
  • Not a treatment, hold, monitoring, or chemotherapy-order. The cardiotoxicity_guide strings are Lyon 2020 expert-opinion estimates of symptomatic CTRCD, not a patient-specific probability.
  • magent does not measure LVEF, troponin, or natriuretic peptides and does not interpret the ECG. Age, LVEF, arrhythmia, biomarkers, and every yes/no factor are caller-assigned.
  • Age bands are exclusive: ≥80 High; 65-79 Medium 2; younger than 65 none. LVEF <50 is High; 50-54 is Medium 2; ≥55 does not score.
  • Concurrent anthracycline plus trastuzumab is High (Lyon 2020 footnote f). Sequential anthracycline before HER2-targeted therapy on the current regimen is Medium 1 and is not added when concurrent is true. Prior remote anthracycline for a previous malignancy is Medium 2 (footnote g).
  • This tool is the HER2-targeted therapy proforma only. Not the anthracycline, VEGF-inhibitor, RAF-MEK, or BCR-ABL HFA-ICOS tables.

Formula

HFA-ICOS HER2 (Lyon 2020): very_high if heart_failure_or_cardiomyopathy or prior_trastuzumab_cardiotoxicity; else high if mi_or_cabg or stable_angina or severe_valvular_heart_disease or lvef_percent<50 or age_years>=80 or concurrent_anthracycline_and_her2 or medium_points>=5; else medium if medium_points 2-4; else low; medium_points = Medium 2 (2) + Medium 1 (1); Medium 2 = lvef 50-54, arrhythmia, elevated_troponin, elevated_bnp, age 65-79, prior_remote_anthracycline, prior_left_chest_or_mediastinal_rt; Medium 1 = hypertension, diabetes, ckd, anthracycline_before_her2 (if not concurrent), current_or_significant_smoker, obesity; cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%

Citation

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
Authors
Lyon AR, Dent S, Stanway S, et al.
Source
Eur J Heart Fail. 2020;22(11):1945-1960
DOI
10.1002/ejhf.1920

Worked example

Age 50, LVEF 60, no factors

Given: age_years=50anthracycline_before_her2=falsearrhythmia=falseckd=falseconcurrent_anthracycline_and_her2=falsecurrent_or_significant_smoker=falsediabetes=falseelevated_bnp=falseelevated_troponin=falseheart_failure_or_cardiomyopathy=falsehypertension=falselvef_percent=60mi_or_cabg=falseobesity=falseprior_left_chest_or_mediastinal_rt=falseprior_remote_anthracycline=falseprior_trastuzumab_cardiotoxicity=falsesevere_valvular_heart_disease=falsestable_angina=false

  1. No Very high or High factors; medium_points = 0
  2. risk_level = low; cardiotoxicity_guide = <2%

Prior trastuzumab cardiotoxicity

Given: age_years=50anthracycline_before_her2=falsearrhythmia=falseckd=falseconcurrent_anthracycline_and_her2=falsecurrent_or_significant_smoker=falsediabetes=falseelevated_bnp=falseelevated_troponin=falseheart_failure_or_cardiomyopathy=falsehypertension=falselvef_percent=60mi_or_cabg=falseobesity=falseprior_left_chest_or_mediastinal_rt=falseprior_remote_anthracycline=falseprior_trastuzumab_cardiotoxicity=truesevere_valvular_heart_disease=falsestable_angina=false

  1. prior_trastuzumab_cardiotoxicity is a Very high factor
  2. risk_level = very_high; cardiotoxicity_guide = >=20%

Concurrent anthracycline and trastuzumab

Given: age_years=50anthracycline_before_her2=falsearrhythmia=falseckd=falseconcurrent_anthracycline_and_her2=truecurrent_or_significant_smoker=falsediabetes=falseelevated_bnp=falseelevated_troponin=falseheart_failure_or_cardiomyopathy=falsehypertension=falselvef_percent=60mi_or_cabg=falseobesity=falseprior_left_chest_or_mediastinal_rt=falseprior_remote_anthracycline=falseprior_trastuzumab_cardiotoxicity=falsesevere_valvular_heart_disease=falsestable_angina=false

  1. concurrent_anthracycline_and_her2 is High (footnote f)
  2. risk_level = high; cardiotoxicity_guide = 10-19%

Age 70 only

Given: age_years=70anthracycline_before_her2=falsearrhythmia=falseckd=falseconcurrent_anthracycline_and_her2=falsecurrent_or_significant_smoker=falsediabetes=falseelevated_bnp=falseelevated_troponin=falseheart_failure_or_cardiomyopathy=falsehypertension=falselvef_percent=60mi_or_cabg=falseobesity=falseprior_left_chest_or_mediastinal_rt=falseprior_remote_anthracycline=falseprior_trastuzumab_cardiotoxicity=falsesevere_valvular_heart_disease=falsestable_angina=false

  1. Age 70 is Medium 2 → medium_points = 2
  2. risk_level = medium; cardiotoxicity_guide = 2-9%

Also searched as

  • HFA-ICOS HER2
  • HER2 baseline CV risk
  • trastuzumab cardiotoxicity risk
  • HFA ICOS HER2-targeted
  • cardio-oncology HER2
  • Lyon 2020 HER2

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/hfa_icos_her2?age_years=50&lvef_percent=60&heart_failure_or_cardiomyopathy=false&prior_trastuzumab_cardiotoxicity=false&mi_or_cabg=false&stable_angina=false&severe_valvular_heart_disease=false&concurrent_anthracycline_and_her2=false&arrhythmia=false&elevated_troponin=false&elevated_bnp=false&prior_remote_anthracycline=false&prior_left_chest_or_mediastinal_rt=false&hypertension=false&diabetes=false&ckd=false&anthracycline_before_her2=false&current_or_significant_smoker=false&obesity=false

Full URL: https://api.magentlab.com/api/calc/hfa_icos_her2?age_years=50&lvef_percent=60&heart_failure_or_cardiomyopathy=false&prior_trastuzumab_cardiotoxicity=false&mi_or_cabg=false&stable_angina=false&severe_valvular_heart_disease=false&concurrent_anthracycline_and_her2=false&arrhythmia=false&elevated_troponin=false&elevated_bnp=false&prior_remote_anthracycline=false&prior_left_chest_or_mediastinal_rt=false&hypertension=false&diabetes=false&ckd=false&anthracycline_before_her2=false&current_or_significant_smoker=false&obesity=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge. 

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/hfa_icos_her2?age_years=50&lvef_percent=60&heart_failure_or_cardiomyopathy=false&prior_trastuzumab_cardiotoxicity=false&mi_or_cabg=false&stable_angina=false&severe_valvular_heart_disease=false&concurrent_anthracycline_and_her2=false&arrhythmia=false&elevated_troponin=false&elevated_bnp=false&prior_remote_anthracycline=false&prior_left_chest_or_mediastinal_rt=false&hypertension=false&diabetes=false&ckd=false&anthracycline_before_her2=false&current_or_significant_smoker=false&obesity=false"

Parameters

Name Type Required Description
age_years integer required Age in years (integer 18-100). Lyon 2020 exclusive bands: ≥80 is High; 65-79 is Medium 2 (2 points); younger than 65 does not score. Age 80 is High, not Medium 2.
lvef_percent integer required Left-ventricular ejection fraction percent (integer 10-80) as assigned by the caller. <50 is High; 50-54 is Medium 2 (2 points); ≥55 does not score. magent does not measure LVEF.
heart_failure_or_cardiomyopathy boolean required Heart failure or cardiomyopathy as assigned by the caller (Lyon 2020 HER2 table Very high). true or false.
prior_trastuzumab_cardiotoxicity boolean required Prior trastuzumab cardiotoxicity as assigned by the caller (Lyon 2020 HER2 table Very high). true or false. magent does not review prior exposure.
mi_or_cabg boolean required Prior myocardial infarction or CABG as assigned by the caller (Lyon 2020 HER2 table High). true or false.
stable_angina boolean required Stable angina as assigned by the caller (Lyon 2020 HER2 table High). true or false.
severe_valvular_heart_disease boolean required Severe valvular heart disease as assigned by the caller (Lyon 2020 HER2 table High). true or false.
concurrent_anthracycline_and_her2 boolean required Anthracycline and trastuzumab delivered concurrently on the current protocol (Lyon 2020 HER2 table footnote f; High). true or false. When true, anthracycline_before_her2 does not add Medium 1 points.
arrhythmia boolean required Atrial fibrillation, atrial flutter, VT, or VF as assigned by the caller (Lyon 2020 HER2 table Medium 2). true or false. magent does not interpret the ECG.
elevated_troponin boolean required Elevated troponin as assigned by the caller (Lyon 2020 HER2 table Medium 2). true or false. magent does not assay troponin.
elevated_bnp boolean required Elevated BNP or NT-proBNP as assigned by the caller (Lyon 2020 HER2 table Medium 2). true or false. magent does not assay natriuretic peptides.
prior_remote_anthracycline boolean required Prior remote anthracycline for a previous malignancy, not the current protocol (Lyon 2020 HER2 table footnote g; Medium 2). true or false.
prior_left_chest_or_mediastinal_rt boolean required Prior left-chest or mediastinal radiotherapy as assigned by the caller (Lyon 2020 HER2 table Medium 2). true or false.
hypertension boolean required Hypertension as assigned by the caller (Lyon 2020 HER2 table Medium 1). true or false.
diabetes boolean required Diabetes mellitus as assigned by the caller (Lyon 2020 HER2 table Medium 1). true or false.
ckd boolean required Chronic kidney disease as assigned by the caller (Lyon 2020 HER2 table Medium 1). true or false.
anthracycline_before_her2 boolean required Current regimen includes anthracycline before HER2-targeted therapy, sequential not concurrent (Lyon 2020 HER2 table Medium 1). true or false. Ignored for points when concurrent_anthracycline_and_her2 is true.
current_or_significant_smoker boolean required Current or significant smoking history as assigned by the caller (Lyon 2020 HER2 table Medium 1). true or false.
obesity boolean required Obesity as assigned by the caller (Lyon 2020 HER2 table Medium 1). true or false. 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.

POST /api/calc/hfa_icos_her2 Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "age_years": "50",
      "anthracycline_before_her2": "false",
      "arrhythmia": "false",
      "ckd": "false",
      "concurrent_anthracycline_and_her2": "false",
      "current_or_significant_smoker": "false",
      "diabetes": "false",
      "elevated_bnp": "false",
      "elevated_troponin": "false",
      "heart_failure_or_cardiomyopathy": "false",
      "hypertension": "false",
      "lvef_percent": "60",
      "mi_or_cabg": "false",
      "obesity": "false",
      "prior_left_chest_or_mediastinal_rt": "false",
      "prior_remote_anthracycline": "false",
      "prior_trastuzumab_cardiotoxicity": "false",
      "severe_valvular_heart_disease": "false",
      "stable_angina": "false"
    },
    {
      "age_years": "50",
      "anthracycline_before_her2": "false",
      "arrhythmia": "false",
      "ckd": "false",
      "concurrent_anthracycline_and_her2": "false",
      "current_or_significant_smoker": "false",
      "diabetes": "false",
      "elevated_bnp": "false",
      "elevated_troponin": "false",
      "heart_failure_or_cardiomyopathy": "false",
      "hypertension": "false",
      "lvef_percent": "60",
      "mi_or_cabg": "false",
      "obesity": "false",
      "prior_left_chest_or_mediastinal_rt": "false",
      "prior_remote_anthracycline": "false",
      "prior_trastuzumab_cardiotoxicity": "false",
      "severe_valvular_heart_disease": "false",
      "stable_angina": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/hfa_icos_her2",
  "items": [
    {
      "components": [
        {
          "factor": "heart_failure_or_cardiomyopathy",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_trastuzumab_cardiotoxicity",
          "points": 0,
          "present": false
        },
        {
          "factor": "mi_or_cabg",
          "points": 0,
          "present": false
        },
        {
          "factor": "stable_angina",
          "points": 0,
          "present": false
        },
        {
          "factor": "severe_valvular_heart_disease",
          "points": 0,
          "present": false
        },
        {
          "value": 60,
          "factor": "lvef_lt_50",
          "points": 0,
          "present": false
        },
        {
          "value": 50,
          "factor": "age_ge_80",
          "points": 0,
          "present": false
        },
        {
          "factor": "concurrent_anthracycline_and_her2",
          "points": 0,
          "present": false
        },
        {
          "value": 60,
          "factor": "lvef_50_54",
          "points": 0,
          "present": false
        },
        {
          "factor": "arrhythmia",
          "points": 0,
          "present": false
        },
        {
          "factor": "elevated_troponin",
          "points": 0,
          "present": false
        },
        {
          "factor": "elevated_bnp",
          "points": 0,
          "present": false
        },
        {
          "value": 50,
          "factor": "age_65_79",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_remote_anthracycline",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_left_chest_or_mediastinal_rt",
          "points": 0,
          "present": false
        },
        {
          "factor": "hypertension",
          "points": 0,
          "present": false
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false
        },
        {
          "factor": "ckd",
          "points": 0,
          "present": false
        },
        {
          "factor": "anthracycline_before_her2",
          "points": 0,
          "present": false
        },
        {
          "factor": "current_or_significant_smoker",
          "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_her2",
      "formula_expression": "HFA-ICOS HER2 (Lyon 2020): very_high if heart_failure_or_cardiomyopathy or prior_trastuzumab_cardiotoxicity; else high if mi_or_cabg or stable_angina or severe_valvular_heart_disease or lvef_percent<50 or age_years>=80 or concurrent_anthracycline_and_her2 or medium_points>=5; else medium if medium_points 2-4; else low; medium_points = Medium 2 (2) + Medium 1 (1); Medium 2 = lvef 50-54, arrhythmia, elevated_troponin, elevated_bnp, age 65-79, prior_remote_anthracycline, prior_left_chest_or_mediastinal_rt; Medium 1 = hypertension, diabetes, ckd, anthracycline_before_her2 (if not concurrent), current_or_significant_smoker, obesity; cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%",
      "age_years": 50,
      "max_score": 20,
      "score": 0,
      "cardiotoxicity_guide": "<2%",
      "lvef_percent": 60,
      "medium_points": 0,
      "risk_level": "low",
      "anthracycline_before_her2": false,
      "concurrent_anthracycline_and_her2": false,
      "high_present": false,
      "very_high_present": false
    },
    {
      "components": [
        {
          "factor": "heart_failure_or_cardiomyopathy",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_trastuzumab_cardiotoxicity",
          "points": 0,
          "present": false
        },
        {
          "factor": "mi_or_cabg",
          "points": 0,
          "present": false
        },
        {
          "factor": "stable_angina",
          "points": 0,
          "present": false
        },
        {
          "factor": "severe_valvular_heart_disease",
          "points": 0,
          "present": false
        },
        {
          "value": 60,
          "factor": "lvef_lt_50",
          "points": 0,
          "present": false
        },
        {
          "value": 50,
          "factor": "age_ge_80",
          "points": 0,
          "present": false
        },
        {
          "factor": "concurrent_anthracycline_and_her2",
          "points": 0,
          "present": false
        },
        {
          "value": 60,
          "factor": "lvef_50_54",
          "points": 0,
          "present": false
        },
        {
          "factor": "arrhythmia",
          "points": 0,
          "present": false
        },
        {
          "factor": "elevated_troponin",
          "points": 0,
          "present": false
        },
        {
          "factor": "elevated_bnp",
          "points": 0,
          "present": false
        },
        {
          "value": 50,
          "factor": "age_65_79",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_remote_anthracycline",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_left_chest_or_mediastinal_rt",
          "points": 0,
          "present": false
        },
        {
          "factor": "hypertension",
          "points": 0,
          "present": false
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false
        },
        {
          "factor": "ckd",
          "points": 0,
          "present": false
        },
        {
          "factor": "anthracycline_before_her2",
          "points": 0,
          "present": false
        },
        {
          "factor": "current_or_significant_smoker",
          "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_her2",
      "formula_expression": "HFA-ICOS HER2 (Lyon 2020): very_high if heart_failure_or_cardiomyopathy or prior_trastuzumab_cardiotoxicity; else high if mi_or_cabg or stable_angina or severe_valvular_heart_disease or lvef_percent<50 or age_years>=80 or concurrent_anthracycline_and_her2 or medium_points>=5; else medium if medium_points 2-4; else low; medium_points = Medium 2 (2) + Medium 1 (1); Medium 2 = lvef 50-54, arrhythmia, elevated_troponin, elevated_bnp, age 65-79, prior_remote_anthracycline, prior_left_chest_or_mediastinal_rt; Medium 1 = hypertension, diabetes, ckd, anthracycline_before_her2 (if not concurrent), current_or_significant_smoker, obesity; cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%",
      "age_years": 50,
      "max_score": 20,
      "score": 0,
      "cardiotoxicity_guide": "<2%",
      "lvef_percent": 60,
      "medium_points": 0,
      "risk_level": "low",
      "anthracycline_before_her2": false,
      "concurrent_anthracycline_and_her2": false,
      "high_present": false,
      "very_high_present": false
    }
  ]
}

Response

Field Type Description
formula string hfa_icos_her2
formula_expression string Lyon 2020 HFA-ICOS HER2 classification expression
score integer Same as medium_points (Medium 1 + Medium 2 only)
max_score integer 20 (seven Medium 2 factors at 2 plus six Medium 1 factors at 1)
medium_points integer Medium 1 (1 each) plus Medium 2 (2 each); High and Very high add 0
risk_level string low, medium, high, or very_high from the Lyon 2020 HER2 table. A class, not a treatment order.
cardiotoxicity_guide string Lyon 2020 expert-opinion symptomatic CTRCD guide: <2%, 2-9%, 10-19%, or >=20%. Not a patient-specific probability.
very_high_present boolean True when any Very high table factor is present
high_present boolean True when any High table factor is present (not medium_points >=5 alone)
age_years integer Age used for the exclusive age bands
lvef_percent integer LVEF percent used for the <50 / 50-54 / ≥55 bands
concurrent_anthracycline_and_her2 boolean Echo of the concurrent anthracycline-plus-trastuzumab flag
anthracycline_before_her2 boolean Echo of the sequential anthracycline-before-HER2 flag (points only when concurrent is false)
components array Per-factor Medium points and present flags
citation object Lyon et al. Eur J Heart Fail 2020 citation
disclaimer string Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup. 

{
  "components": [
    {
      "factor": "heart_failure_or_cardiomyopathy",
      "points": 0,
      "present": false
    },
    {
      "factor": "prior_trastuzumab_cardiotoxicity",
      "points": 0,
      "present": false
    },
    {
      "factor": "mi_or_cabg",
      "points": 0,
      "present": false
    },
    {
      "factor": "stable_angina",
      "points": 0,
      "present": false
    },
    {
      "factor": "severe_valvular_heart_disease",
      "points": 0,
      "present": false
    },
    {
      "value": 60,
      "factor": "lvef_lt_50",
      "points": 0,
      "present": false
    },
    {
      "value": 50,
      "factor": "age_ge_80",
      "points": 0,
      "present": false
    },
    {
      "factor": "concurrent_anthracycline_and_her2",
      "points": 0,
      "present": false
    },
    {
      "value": 60,
      "factor": "lvef_50_54",
      "points": 0,
      "present": false
    },
    {
      "factor": "arrhythmia",
      "points": 0,
      "present": false
    },
    {
      "factor": "elevated_troponin",
      "points": 0,
      "present": false
    },
    {
      "factor": "elevated_bnp",
      "points": 0,
      "present": false
    },
    {
      "value": 50,
      "factor": "age_65_79",
      "points": 0,
      "present": false
    },
    {
      "factor": "prior_remote_anthracycline",
      "points": 0,
      "present": false
    },
    {
      "factor": "prior_left_chest_or_mediastinal_rt",
      "points": 0,
      "present": false
    },
    {
      "factor": "hypertension",
      "points": 0,
      "present": false
    },
    {
      "factor": "diabetes",
      "points": 0,
      "present": false
    },
    {
      "factor": "ckd",
      "points": 0,
      "present": false
    },
    {
      "factor": "anthracycline_before_her2",
      "points": 0,
      "present": false
    },
    {
      "factor": "current_or_significant_smoker",
      "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_her2",
  "formula_expression": "HFA-ICOS HER2 (Lyon 2020): very_high if heart_failure_or_cardiomyopathy or prior_trastuzumab_cardiotoxicity; else high if mi_or_cabg or stable_angina or severe_valvular_heart_disease or lvef_percent<50 or age_years>=80 or concurrent_anthracycline_and_her2 or medium_points>=5; else medium if medium_points 2-4; else low; medium_points = Medium 2 (2) + Medium 1 (1); Medium 2 = lvef 50-54, arrhythmia, elevated_troponin, elevated_bnp, age 65-79, prior_remote_anthracycline, prior_left_chest_or_mediastinal_rt; Medium 1 = hypertension, diabetes, ckd, anthracycline_before_her2 (if not concurrent), current_or_significant_smoker, obesity; cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%",
  "age_years": 50,
  "max_score": 20,
  "score": 0,
  "cardiotoxicity_guide": "<2%",
  "lvef_percent": 60,
  "medium_points": 0,
  "risk_level": "low",
  "anthracycline_before_her2": false,
  "concurrent_anthracycline_and_her2": false,
  "high_present": false,
  "very_high_present": false
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP Code When
400 invalid_hfa_icos_her2 Lyon 2020 HFA-ICOS HER2-targeted therapy inputs must match that table's age, LVEF, anthracycline timing, and yes/no factors. Returned before settlement; you are not charged.
400 invalid_items POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400 invalid_item_count items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400 invalid_item each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

  • HFA-ICOS anthracycline baseline CV risk — 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 — Return the 1994 NYHA functional capacity class 1-4 from a caller-assigned integer, with the published class description.
  • 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 — 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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /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.