MAGENT

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HFA-ICOS VEGF-inhibitor baseline CV risk

Classify Lyon 2020 HFA-ICOS baseline cardiovascular risk for someone scheduled to receive VEGF inhibitors or VEGF TKIs, using that table's very-high, High, Medium 2, and Medium 1 rows.

LIVE $0.005 USDC GET /api/calc/hfa_icos_vegf

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

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

What it computes

Classify Lyon 2020 HFA-ICOS baseline cardiovascular risk for someone scheduled to receive VEGF inhibitors or VEGF TKIs, using that table's very-high, High, Medium 2, and Medium 1 rows.

When to use

When an agent already has caller-assigned age, sex, LVEF, QTc, and the VEGF-inhibitor table's yes/no factors and needs the published low/medium/high/very-high class plus cardiotoxicity guide. magent does not measure QTc or decide whether to start a VEGF inhibitor.

When not to use

  • Not a medical device. Not a treatment, hold, or monitoring order for VEGF inhibitors or VEGF TKIs.
  • Cardiotoxicity percentages are a published guide (low <2%, medium 2-9%, high 10-19%, very high >=20%). The paper states evidence for defining absolute risk is limited.
  • magent does not measure QTc, LVEF, troponin, BNP, lipids, eGFR, or BMI, and does not assign vascular disease, arrhythmia, or smoking history.
  • Hypertension, diabetes, hyperlipidemia, CKD, proteinuria, smoking, and obesity are caller-assigned flags matching Lyon 2020 footnotes, not computed from labs.
  • One Medium 1 factor remains low risk. Age >=75 is High only. QTc >=480 ms is High only. LVEF <50% is High only.

Formula

HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). 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, no factors

Given: age_years=50arrhythmia=falsearterial_vascular_disease=falseckd=falsecurrent_or_significant_smoker=falsediabetes=falseelevated_bnp=falseelevated_troponin=falseheart_failure_or_cardiomyopathy=falsehyperlipidemia=falsehypertension=falselvef_percent=60obesity=falseprior_anthracycline=falseprior_left_chest_or_mediastinal_rt=falseproteinuria=falseqtc_ms=400sex=femalevenous_thrombosis=false

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

Arterial vascular disease

Given: age_years=50arrhythmia=falsearterial_vascular_disease=trueckd=falsecurrent_or_significant_smoker=falsediabetes=falseelevated_bnp=falseelevated_troponin=falseheart_failure_or_cardiomyopathy=falsehyperlipidemia=falsehypertension=falselvef_percent=60obesity=falseprior_anthracycline=falseprior_left_chest_or_mediastinal_rt=falseproteinuria=falseqtc_ms=400sex=femalevenous_thrombosis=false

  1. arterial_vascular_disease is a very-high factor
  2. risk_level very_high; cardiotoxicity_guide >=20%

Hypertension only

Given: age_years=50arrhythmia=falsearterial_vascular_disease=falseckd=falsecurrent_or_significant_smoker=falsediabetes=falseelevated_bnp=falseelevated_troponin=falseheart_failure_or_cardiomyopathy=falsehyperlipidemia=falsehypertension=truelvef_percent=60obesity=falseprior_anthracycline=falseprior_left_chest_or_mediastinal_rt=falseproteinuria=falseqtc_ms=400sex=femalevenous_thrombosis=false

  1. hypertension is a High factor on the VEGF-inhibitor table
  2. risk_level high; cardiotoxicity_guide 10-19%

Also searched as

  • HFA-ICOS VEGF
  • VEGF inhibitor cardiovascular risk
  • VEGF TKI baseline risk
  • Lyon 2020 VEGF
  • cardio-oncology VEGF inhibitors
  • HFA ICOS VEGF inhibitors

Try

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

/api/calc/hfa_icos_vegf?age_years=50&sex=female&lvef_percent=60&qtc_ms=400&heart_failure_or_cardiomyopathy=false&arterial_vascular_disease=false&venous_thrombosis=false&hypertension=false&prior_anthracycline=false&arrhythmia=false&elevated_troponin=false&elevated_bnp=false&diabetes=false&hyperlipidemia=false&ckd=false&proteinuria=false&prior_left_chest_or_mediastinal_rt=false&current_or_significant_smoker=false&obesity=false

Full URL: https://api.magentlab.com/api/calc/hfa_icos_vegf?age_years=50&sex=female&lvef_percent=60&qtc_ms=400&heart_failure_or_cardiomyopathy=false&arterial_vascular_disease=false&venous_thrombosis=false&hypertension=false&prior_anthracycline=false&arrhythmia=false&elevated_troponin=false&elevated_bnp=false&diabetes=false&hyperlipidemia=false&ckd=false&proteinuria=false&prior_left_chest_or_mediastinal_rt=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_vegf?age_years=50&sex=female&lvef_percent=60&qtc_ms=400&heart_failure_or_cardiomyopathy=false&arterial_vascular_disease=false&venous_thrombosis=false&hypertension=false&prior_anthracycline=false&arrhythmia=false&elevated_troponin=false&elevated_bnp=false&diabetes=false&hyperlipidemia=false&ckd=false&proteinuria=false&prior_left_chest_or_mediastinal_rt=false&current_or_significant_smoker=false&obesity=false"

Parameters

Name Type Required Description
age_years integer required Integer age in years (18-100) as assigned by the caller. Lyon 2020 VEGF-inhibitor table: >=75 High; 65-74 Medium 1; <65 no age points. Bands are exclusive. magent does not read an identity document.
sex string required male or female as assigned by the caller. Used only for the sex-specific borderline QTc Medium 2 band (men 450-479 ms; women 460-479 ms).
lvef_percent integer required Baseline left-ventricular ejection fraction, integer percent 10-80, as assigned by the caller. <50 High; 50-54 Medium 2; >=55 no LVEF points. magent does not read an echocardiogram.
qtc_ms integer required Baseline QTc in milliseconds, integer 300-700, as assigned by the caller. >=480 High; men 450-479 Medium 2; women 460-479 Medium 2. magent does not measure QTc.
heart_failure_or_cardiomyopathy boolean required Heart failure or cardiomyopathy (Lyon 2020 VEGF-inhibitor table, very high). Caller-assigned. true or false.
arterial_vascular_disease boolean required Arterial vascular disease: IHD, PCI, CABG, stable angina, TIA, stroke, or PVD as one caller bool (Lyon 2020 VEGF-inhibitor table, very high). true or false. magent does not diagnose vascular disease.
venous_thrombosis boolean required Venous thrombosis (DVT or PE) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, High). true or false.
hypertension boolean required Hypertension (SBP >140 mmHg or DBP >90 mmHg, or on treatment) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, High). true or false. magent does not read a blood-pressure cuff.
prior_anthracycline boolean required Prior anthracycline exposure as assigned by the caller (Lyon 2020 VEGF-inhibitor table, High). true or false.
arrhythmia boolean required Arrhythmia (atrial fibrillation, atrial flutter, ventricular tachycardia, or ventricular fibrillation) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 2). true or false.
elevated_troponin boolean required Elevated baseline troponin above the local laboratory upper limit of normal as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not assay troponin.
elevated_bnp boolean required Elevated baseline BNP or NT-proBNP above the local laboratory upper limit of normal as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not assay BNP.
diabetes boolean required Diabetes mellitus (glycated haemoglobin >7.0% or >53 mmol/mol, or on treatment) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false.
hyperlipidemia boolean required Hyperlipidemia (non-HDL cholesterol >3.8 mmol/L or >145 mg/dL) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not convert lipid units.
ckd boolean required Chronic kidney disease (eGFR <60 mL/min/1.73 m2) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not compute eGFR.
proteinuria boolean required Proteinuria as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false.
prior_left_chest_or_mediastinal_rt boolean required Prior radiotherapy to the left chest or mediastinum as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false.
current_or_significant_smoker boolean required Current smoker or significant smoking history as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false.
obesity boolean required Obesity (BMI >30 kg/m2) as assigned by the caller (Lyon 2020 VEGF-inhibitor 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_vegf 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",
      "arrhythmia": "false",
      "arterial_vascular_disease": "false",
      "ckd": "false",
      "current_or_significant_smoker": "false",
      "diabetes": "false",
      "elevated_bnp": "false",
      "elevated_troponin": "false",
      "heart_failure_or_cardiomyopathy": "false",
      "hyperlipidemia": "false",
      "hypertension": "false",
      "lvef_percent": "60",
      "obesity": "false",
      "prior_anthracycline": "false",
      "prior_left_chest_or_mediastinal_rt": "false",
      "proteinuria": "false",
      "qtc_ms": "400",
      "sex": "female",
      "venous_thrombosis": "false"
    },
    {
      "age_years": "50",
      "arrhythmia": "false",
      "arterial_vascular_disease": "false",
      "ckd": "false",
      "current_or_significant_smoker": "false",
      "diabetes": "false",
      "elevated_bnp": "false",
      "elevated_troponin": "false",
      "heart_failure_or_cardiomyopathy": "false",
      "hyperlipidemia": "false",
      "hypertension": "false",
      "lvef_percent": "60",
      "obesity": "false",
      "prior_anthracycline": "false",
      "prior_left_chest_or_mediastinal_rt": "false",
      "proteinuria": "false",
      "qtc_ms": "400",
      "sex": "female",
      "venous_thrombosis": "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_vegf",
  "items": [
    {
      "components": [
        {
          "factor": "heart_failure_or_cardiomyopathy",
          "points": 0,
          "present": false,
          "tier": "very_high"
        },
        {
          "factor": "arterial_vascular_disease",
          "points": 0,
          "present": false,
          "tier": "very_high"
        },
        {
          "factor": "venous_thrombosis",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "lvef_lt_50",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "qtc_ge_480",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "age_ge_75",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "hypertension",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "prior_anthracycline",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "lvef_50_to_54",
          "points": 0,
          "present": false,
          "tier": "medium_2"
        },
        {
          "factor": "borderline_qtc",
          "points": 0,
          "present": false,
          "tier": "medium_2"
        },
        {
          "factor": "arrhythmia",
          "points": 0,
          "present": false,
          "tier": "medium_2"
        },
        {
          "factor": "elevated_troponin",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "elevated_bnp",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "age_65_to_74",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "hyperlipidemia",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "ckd",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "proteinuria",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "prior_left_chest_or_mediastinal_rt",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "current_or_significant_smoker",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "obesity",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        }
      ],
      "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_vegf",
      "formula_expression": "HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%",
      "age_years": 50,
      "sex": "female",
      "qtc_ms": 400,
      "cardiotoxicity_guide": "<2%",
      "lvef_percent": 60,
      "medium_points": 0,
      "risk_level": "low",
      "high_factor": false,
      "very_high_factor": false
    },
    {
      "components": [
        {
          "factor": "heart_failure_or_cardiomyopathy",
          "points": 0,
          "present": false,
          "tier": "very_high"
        },
        {
          "factor": "arterial_vascular_disease",
          "points": 0,
          "present": false,
          "tier": "very_high"
        },
        {
          "factor": "venous_thrombosis",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "lvef_lt_50",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "qtc_ge_480",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "age_ge_75",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "hypertension",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "prior_anthracycline",
          "points": 0,
          "present": false,
          "tier": "high"
        },
        {
          "factor": "lvef_50_to_54",
          "points": 0,
          "present": false,
          "tier": "medium_2"
        },
        {
          "factor": "borderline_qtc",
          "points": 0,
          "present": false,
          "tier": "medium_2"
        },
        {
          "factor": "arrhythmia",
          "points": 0,
          "present": false,
          "tier": "medium_2"
        },
        {
          "factor": "elevated_troponin",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "elevated_bnp",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "age_65_to_74",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "hyperlipidemia",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "ckd",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "proteinuria",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "prior_left_chest_or_mediastinal_rt",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "current_or_significant_smoker",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        },
        {
          "factor": "obesity",
          "points": 0,
          "present": false,
          "tier": "medium_1"
        }
      ],
      "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_vegf",
      "formula_expression": "HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%",
      "age_years": 50,
      "sex": "female",
      "qtc_ms": 400,
      "cardiotoxicity_guide": "<2%",
      "lvef_percent": 60,
      "medium_points": 0,
      "risk_level": "low",
      "high_factor": false,
      "very_high_factor": false
    }
  ]
}

Response

Field Type Description
formula string hfa_icos_vegf
formula_expression string Lyon 2020 VEGF-inhibitor HFA-ICOS classification expression
age_years integer Integer age 18-100 used
sex string male or female used for borderline QTc
lvef_percent integer Integer LVEF percent 10-80 used
qtc_ms integer Integer QTc in milliseconds 300-700 used
very_high_factor boolean true if any Lyon 2020 VEGF-inhibitor very-high factor is present
high_factor boolean true if any Lyon 2020 VEGF-inhibitor High factor is present
medium_points integer Sum of Medium 1 and Medium 2 points only
risk_level string low, medium, high, or very_high from the published classification
cardiotoxicity_guide string Published guide: <2%, 2-9%, 10-19%, or >=20%
components array Per-factor present flag, points, and tier
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,
      "tier": "very_high"
    },
    {
      "factor": "arterial_vascular_disease",
      "points": 0,
      "present": false,
      "tier": "very_high"
    },
    {
      "factor": "venous_thrombosis",
      "points": 0,
      "present": false,
      "tier": "high"
    },
    {
      "factor": "lvef_lt_50",
      "points": 0,
      "present": false,
      "tier": "high"
    },
    {
      "factor": "qtc_ge_480",
      "points": 0,
      "present": false,
      "tier": "high"
    },
    {
      "factor": "age_ge_75",
      "points": 0,
      "present": false,
      "tier": "high"
    },
    {
      "factor": "hypertension",
      "points": 0,
      "present": false,
      "tier": "high"
    },
    {
      "factor": "prior_anthracycline",
      "points": 0,
      "present": false,
      "tier": "high"
    },
    {
      "factor": "lvef_50_to_54",
      "points": 0,
      "present": false,
      "tier": "medium_2"
    },
    {
      "factor": "borderline_qtc",
      "points": 0,
      "present": false,
      "tier": "medium_2"
    },
    {
      "factor": "arrhythmia",
      "points": 0,
      "present": false,
      "tier": "medium_2"
    },
    {
      "factor": "elevated_troponin",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "elevated_bnp",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "age_65_to_74",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "diabetes",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "hyperlipidemia",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "ckd",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "proteinuria",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "prior_left_chest_or_mediastinal_rt",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "current_or_significant_smoker",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    },
    {
      "factor": "obesity",
      "points": 0,
      "present": false,
      "tier": "medium_1"
    }
  ],
  "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_vegf",
  "formula_expression": "HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%",
  "age_years": 50,
  "sex": "female",
  "qtc_ms": 400,
  "cardiotoxicity_guide": "<2%",
  "lvef_percent": 60,
  "medium_points": 0,
  "risk_level": "low",
  "high_factor": false,
  "very_high_factor": 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_vegf Lyon 2020 HFA-ICOS VEGF-inhibitor inputs must match that table's age, LVEF, QTc, sex, 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.