In the future, a score to guide clinicians and patients regarding treatment options may therefore include markers of metabolic distress (e.g. plasma lactate concentrations), inflammation (e.g. poGPS, NLR), measures of physiological compromise (e.g. MAP<80 mmHg; SaO2 stratified for FiO2), biomarkers of myocardial injury (high sensitivity troponin and BNP), radiological evidence of right heart strain (bowing of the septum or RV: LV ratio ≥1.0) combined with measures of clot burden (e.g. Qanadli score) and coronary artery calcification score. This evidence concerns the gene NPPB and coronary artery calcification.