Cardiovascular Risk PROCAM Score

Predicts 10-year cardiovascular risk based on risk factors like history of MI, diabetes or high cholesterol.

In the text below the calculator there is more information about the score and its interpretation.


The PROCAM score stratifies 10-year cardiac risk in patients with cardiovascular risk factors such as hypertension, diabetes, high cholesterol or history of myocardial infarction.

The score is based on the Prospective Cardiovascular Münster (PROCAM) cardiovascular epidemiology study.


Each of the eight items in the score are weighted differently, depending on their independent predictor value for future cardiovascular events.

The final score is given an overall 10-year cardiovascular risk:

PROCAM score Cardiovascular risk
≤20 <1%
21 - 28 1 - 2%
29 - 37 2 - 5%
38 - 44 5 - 10%
45 - 53 10 - 20%
54 - 61 20 - 40%
≥62 >40%

1

Age

2

History of diabetes

3

Smoking

4

Family history of MI

5

LDL cholesterol in mg/dL

6

HDL cholesterol in mg/dL

7

Triglycerides in mg/dL

8

Systolic blood pressure in mmHg

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PROCAM explained

This is a stratifying tool for cardiovascular risk based on patient history and laboratory results.

It was developed during the Prospective Cardiovascular Münster (PROCAM) cardiovascular epidemiology study and consists of 8 items each weighted differently in the final score.

The PROCAM was praised for including risk factors such as family history of myocardial infarction or cholesterol values, factors that are omitted in other cardiac scores.

The following table introduces the 8 risk factors and their answer choices:

PROCAM items Answer choices (points)
Age <39 (0)
40 – 44 (6)
45 – 49 (11)
50 – 54 (16)
55 – 59 (21)
>60 (26)
History of diabetes Yes (6)
No (0)
Smoking Yes (8)
No (0)
Family history of myocardial infarction* Yes (4)
No (0)
LDL cholesterol in mg/dL <100 (0)
100 - 129 (5)
130 - 159 (10)
160 - 189 (14)
>189 (20)
HDL cholesterol in mg/dL <35 (11)
35 - 44 (8)
45 - 54 (5)
>54 (0)
Triglycerides in mg/dL <100 (0)
100 - 149 (2)
150 - 199 (3)
>199 (4)
Systolic blood pressure in mmHg (hypertension as risk factor of CVD) <120 (0)
120 - 129 (2)
130 - 139 (3)
140 - 159 (5)
≥160 (8)

*It is considered increased risk when first degree male has suffered from myocardial infarction before the age of 55, or female first degree relative suffered from MI before the age of 65.

Compared to the SCORE (the European CVD risk-assessment tool), PROCAM performed better because of showing more caution in predicting patients at high cardiac risk whilst the SCORE tended to over predict risk and overestimate number of patients at high risk.

Other similar cardiovascular risk predictors include Framingham score and the UKPDS cardiac risk tool, the latter being specific for patients diagnosed with type 2 diabetes.

 

Cardiovascular risk

The overall PROCAM score varies from 0 to 87, 0 meaning that there are no risk factors (the patient is younger than 39), whilst 87 would suggest that the patient is a smoker older than 60 who presents all risk CVD risk factors.

The risk of an acute coronary event in the following 10 years is introduced in the table below (linked to PROCAM scores):

PROCAM score Cardiovascular risk
≤20 <1%
21 - 28 1 - 2%
29 - 37 2 - 5%
38 - 44 5 - 10%
45 - 53 10 - 20%
54 - 61 20 - 40%
≥62 >40%
 

About the study

The PROCAM score was developed by Assmann et al. in 2002, during the Prospective Cardiovascular Münster (PROCAM) study. It involved 5,389 men with ages between 35 and 65. During the 10 year follow up, 325 acute coronary events resulted.

The scoring system was developed based on beta-coefficients of 8 independent risk variables. These are ranked in order of importance as follows: age, LDL cholesterol, smoking, HDL cholesterol, systolic blood pressure, family history of premature myocardial infarction, diabetes mellitus, and triglycerides.

The PROCAM accurately predicted observed coronary events and can help with stratifying risk of myocardial infarction in practice.

 

Original source

Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Münster (PROCAM) study. Circulation. 2002; 105(3):310-5.

Other references

1. Assmann G, Schulte H, Cullen P, Seedorf U. Assessing risk of myocardial infarction and stroke: new data from the Prospective Cardiovascular Münster (PROCAM) study. Eur J Clin Invest 2007; 37(12):925-32.

2. Pencina MJ, D'Agostino RB, Larson MG, Massaro J, Vasan RS. Predicting the Thirty-year Risk of Cardiovascular Disease: The Framingham Heart Study. Circulation. 2009; 119(24): 3078–3084.

3. Versteylen MO, Joosen IA, Shaw LJ, Narula J, Hofstra L. Comparison of Framingham, PROCAM, SCORE, and Diamond Forrester to predict coronary atherosclerosis and cardiovascular events. J Nucl Cardiol. 2011; 18(5): 904–911.


App Version: 1.0.1

Coded By: MDApp

Specialty: Cardiology

System: Cardiovascular

Objective: Risk Prediction

Type: Score

No. Of Items: 8

Year Of Study: 2002

Abbreviation: PROCAM

Article By: Denise Nedea

Published On: June 12, 2017 · 11:59 AM

Last Checked: June 12, 2017

Next Review: June 12, 2018