Coronary Artery Disease Scores

BCIS-JS Calculator – British Cardiovascular Intervention Society Jeopardy Score

Clinical calculation support · Verify results before clinical use

Angiographic assessment

Enter the coronary anatomy and graft findings from the angiogram. Use visual diameter stenosis estimates.

—BCIS-JS

Assessment setting

Calculate the score for the angiographic state being assessed (before or after revascularisation).

Assessment timepoint

Coronary dominanceChoose the dominant system supplying the posterior descending artery.

Previous CABG

Left main stem stenosisSignificant LMS disease is defined as ≥50% diameter stenosis.

Native coronary arteries

For non-LMS disease, significant stenosis is ≥70%. Score the major branch supplying the largest myocardial territory when a vessel has multiple branches.

Proximal LAD (before major diagonal)

Mid LAD (after major diagonal)

Major diagonal

Proximal RCA (before PDA)

Posterior descending artery (PDA)

Proximal LCx (before OM)

Mid LCx (after OM)

Major obtuse marginal (OM)

Bypass graft assessment

For each listed graft, select patent with stenosis <70% and adequate runoff only when both conditions are met. A severely diseased, occluded, poor-runoff, or absent graft receives no deduction.

LAD graft (distal to diagonal)Graft status

Major diagonal graftGraft status

Major obtuse marginal graftGraft status

LCx graft distal to OM (left dominance)Graft status

RCA graft (proximal to PDA)Graft status

PDA graftGraft status

—Score / 12

Estimated anatomical myocardial jeopardy

Complete the assessment

Select the angiographic findings to calculate the BCIS-JS.

Score breakdown

Awaiting angiographic inputs.

About the BCIS-JS

The British Cardiovascular Intervention Society Myocardial Jeopardy Score (BCIS-JS) is an angiographic score that provides a semi-quantitative estimate of the extent of myocardium at risk from significant coronary artery disease. It is adapted from the Duke Jeopardy Score and includes left main stem disease and patients with previous coronary artery bypass grafting.

The score is based on the coronary anatomy and the territories subtended by significant stenoses. It should be calculated using all coronary disease, not only disease supplying currently viable myocardium.

Scoring principles

Native coronary segment	Significant stenosis	Score contribution
Left main stem	≥50%	8 (plus dominance-dependent component)
Proximal LAD	≥70%	6
Mid LAD / major diagonal	≥70%	2 each
Proximal RCA (right dominant)	≥70%	4
PDA (right dominant)	≥70%	2
Proximal LCx (left dominant)	≥70%	6
Mid LCx / major OM (left dominant)	≥70%	2 each

Interpretation and clinical context

The score ranges from 0 to 12. Higher scores indicate a larger anatomical territory at risk. In a CMR perfusion validation study, a score ≥6 identified myocardial ischaemic burden ≥12% with 68% sensitivity and 91% specificity (AUC 0.87). This is a study-derived threshold, not a universal treatment threshold.

For pre- and post-revascularisation assessment, calculate the score independently for each angiographic state. A revascularisation index may be calculated as (pre-PCI score − post-PCI score) / pre-PCI score when the pre-PCI score is greater than zero.

References

De Silva K, Morton G, Sicard P, et al.Completeness of revascularisation predicts mortality following percutaneous coronary intervention: utility of the BCIS-1 Jeopardy Score. Heart. 2011;97:A24. doi:10.1136/heartjnl-2011-300198.33

Morton GD, De Silva K, Ishida M, et al.Validation of the BCIS-1 Myocardial Jeopardy score using cardiac magnetic resonance perfusion imaging. Clin Physiol Funct Imaging. 2013;33(2):101–108. doi:10.1111/j.1475-097X.2012.01167.x

Rosmaningtyas CAA, Rampengan SH.Coronary angiographic scoring systems to predict prognosis of ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Intisari Sains Medis. 2024;15(1):272–284. doi:10.15562/ism.v15i1.1953

Japanese Circulation Society / Japanese Society for Cardiovascular Surgery.Guideline on Revascularization of Stable Coronary Artery Disease. Circulation Journal. 2022. Official guideline.

Clinical disclaimer: BCIS-JS is an anatomical, semi-quantitative scoring instrument and does not directly measure myocardial perfusion, viability, scar, or fractional flow reserve. It must not be used as the sole basis for revascularisation decisions. Interpret angiographic findings in the context of symptoms, physiology, ventricular function, ischaemia, viability, comorbidities, and the Heart Team assessment. The graft deductions require adequate distal runoff and graft stenosis below 70%.