RCRI Calculator

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Intraperitoneal (abdominal), intrathoracic, or suprainguinal vascular procedures. Does not include superficial, orthopaedic, or low-risk procedures.
Includes prior myocardial infarction, positive exercise stress test, current chest pain presumed to be ischemic, use of nitrates, or pathological Q waves on ECG.
Pulmonary edema, bilateral rales, S3 gallop, paroxysmal nocturnal dyspnea, or chest X-ray showing pulmonary vascular redistribution.
Prior stroke or transient ischemic attack (TIA). Does not include asymptomatic carotid stenosis alone.
Pre-operative insulin therapy only. Oral antidiabetic agents or diet-controlled diabetes do not qualify.
Serum creatinine above 2.0 mg/dL or 177 µmol/L measured before surgery. Reflects chronic kidney disease as a cardiac risk amplifier.
RCRI ScoreVery Low Risk
0points

Total Revised Cardiac Risk Index score (0-6)

Estimated MACE Risk0%
Risk ClassClass I
Risk CategoryVery Low
0 points
Very Low (0)<1Low (1)1-2Intermediate (2)2-3High (3+)3+

RCRI Score 0 - Very Low perioperative cardiac risk (~0.4%).

  • No RCRI risk factors are present. This is the lowest risk profile in the Lee 1999 dataset.
  • The estimated 30-day MACE rate for Class I (RCRI 0) is approximately 0.4% based on the Lee et al. 1999 validation cohort.

Next stepVery low risk - proceed with surgery. No additional preoperative cardiac testing is typically required unless functional capacity is poor or new symptoms are present.

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