MAGGIC Risk Calculator for Heart Failure
Why Use
Heart failure with preserved EF has significant mortality and is rising in incidence. Predictive models to stratify risk for these patients are necessary.
When to Use
Adult patients with heart failure and preserved EF.
Formula
Pearls / Pitfalls
The Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) Risk Calculator assigns an integer score based on heart failure risk factors to predict mortality at 1 and 3 years. Can be used in heart failure patients with reduced or preserved ejection fraction (EF). Not yet externally validated for patients with reduced EF. Excludes biomarkers known to correlate with mortality, such as B-type natriuretic peptide.
Advice
Consider individualized choice of pharmacotherapy (e.g. beta blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers) for treatment of heart failure based on score.
More Information
Risk Factor Points Male Smoker Diabetic COPD Heart failure first diagnosed ≥18 months ago Not on beta blocker Not on ACE-I/ARB +1 +1 +3 +2 +2 +3 +1 Ejection fraction (EF) <20 20-24 25-29 30-34 35-39 ≥40 +7 +6 +5 +3 +2 +0 NYHA class 1 2 3 4 +0 +2 +6 +8 Creatinine* <90 90-109 110-129 130-149 150-169 170-209 210-249 ≥250 +0 +1 +2 +3 +4 +5 +6 +8 BMI <15 15-19 20-24 25-29 ≥30 +6 +5 +3 +2 +0 Extra for systolic BP (mm Hg) if EF <30 <110 110-119 120-129 130-139 140-149 ≥150 +5 +4 +3 +2 +1 +0 Extra for systolic BP (mm Hg) if EF 30-39 <110 110-119 120-129 130-139 140-149 ≥150 +3 +2 +1 +1 +0 +0 Extra for systolic BP (mm Hg) if EF ≥40 <110 110-119 120-129 130-139 140-149 ≥150 +2 +1 +1 +0 +0 +0 Extra for age (years) if EF <30 <55 55-59 60-64 65-69 70-74 75-79 ≥80 +0 +1 +2 +4 +6 +8 +10 Extra for age (years) if EF 30-39 <55 55-59 60-64 65-69 70-74 75-79 ≥80 +0 +2 +4 +6 +8 +10 +13 Extra for age (years) if EF ≥40 <55 55-59 60-64 65-69 70-74 75-79 ≥80 +0 +3 +5 +7 +9 +12 +15 *Note: while this score uses creatinine as a proxy for renal function, eGFR is generally considered a more accurate indicator.