About The Madison Score

The MADISON Score is a quick, bedside clinical tool developed to help identify patients with non–ST-elevation acute coronary syndrome (NSTE-ACS) who may have significant left main and/or three-vessel coronary artery disease (LM/3VD).

The score’s name reflects the key predictors it incorporates: Male sex, Age (≥65 years), Diabetes mellitus, Ischemic ECG changes, increased heart rate (>90 bpm), Stroke history, and Onset of heart failure signs or symptoms for NSTE-ACS — together forming the MADISON acronym. These seven simple variables are routinely available at initial presentation, allowing for fast, practical bedside use. 

Designed for speed and simplicity, it can be used:

• At the bedside or in emergency settings for early triage and transfer decisions
• In resource-limited environments to prioritize patients needing urgent angiography or revascularization
   

A score of ≥4 indicates high specificity for LM/3VD, aiding in focused and timely care.

Disclaimer

This calculator is for informational purposes only and is not a substitute for clinical judgment. It should complement, not replace, contemporary medical decision-making.

Reference: Rachwan RJ, Chehab O, et al., Raval AN, Int J Cardiol 2026;444:133976