A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure

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• dc.contributor.author Moliner Abós, Carles
• dc.contributor.author Mojón Álvarez, Diana
• dc.contributor.author Rivas-Lasarte, Mercedes
• dc.contributor.author Belarte Tornero, Laia Carla
• dc.contributor.author Pamies Besora, Julia
• dc.contributor.author Solé-González, Eduard
• dc.contributor.author Fluvià Brugues, Paula
• dc.contributor.author Zegrí Reiriz, Isabel
• dc.contributor.author López-López, Laura
• dc.contributor.author Brossa, Vicens
• dc.contributor.author Pirla, María J.
• dc.contributor.author Mesado, Nuria
• dc.contributor.author Mirabet, Sonia
• dc.contributor.author Roig, Eulàlia
• dc.contributor.author Álvarez-García, Jesus
• dc.date.accessioned 2021-06-15T06:56:49Z
• dc.date.available 2021-06-15T06:56:49Z
• dc.date.issued 2021
• dc.description.abstract Introduction: Sacubitril/valsartan (SV) promotes cardiac remodeling and improves prognosis in patients with heart failure (HF). However, the response to the drug may vary between patients and its implementation in daily clinical practice has been slower than expected. Our objective was to develop a score predicting the super-response to SV in HF outpatients. Methods: This is a retrospective analysis of 185 consecutive patients prescribed SV from two tertiary hospitals between September 2016 and February 2018. Super-responder was defined as a patient taking the drug and (i) without HF admissions, death, or heart transplant, and (ii) with a ≥50% reduction in NT-proBNP levels and/or an increase of ≥10 points in LVEF in a 12-month follow-up period after starting SV. Clinical, echocardiographic, ECG, and biochemical variables were used in a logistic regression analysis to construct a score for super-response to SV which was internally validated using bootstrap method. Results: Out of 185 patients, 65 (35%) fulfilled the super-responder criteria. Predictors for super-response to SV were absence of both previous aldosterone antagonist and diuretic treatment, NYHA I-II class, female gender, previous 1-year HF admission, and sinus rhythm. An integrating score distinguished a low- (<25%), intermediate- (∼46%), and high-probability (>80%) for 1-year super-response to SV. The AUC for the model was 0.72 (95%CI: 0.64-0.80), remaining consistent after internal validation. Conclusion: One-third of our patients presented a super-response to SV. We propose an easy-to-calculate score to predict super-response to SV after 1-year initiation based on variables that are currently assessed in clinical practice.
• dc.format.mimetype application/pdf
• dc.identifier.citation Moliner-Abós C, Mojón Álvarez D, Rivas-Lasarte M, Belarte LC, Pamies Besora J, Solé-González E, Fluvià-Brugues P, Zegrí-Reiriz I, López López L, Brossa V, Pirla MJ, Mesado N, Mirabet S, Roig E, Álvarez-García J. A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure. Front Physiol. 2021;12:642117. DOI: 10.3389/fphys.2021.642117
• dc.identifier.doi http://dx.doi.org/10.3389/fphys.2021.642117
• dc.identifier.issn 1664-042X
• dc.identifier.uri http://hdl.handle.net/10230/47878
• dc.language.iso eng
• dc.publisher Frontiers
• dc.relation.ispartof Front Physiol. 2021;12:642117
• dc.rights © 2021 Moliner-Abós, Mojón Álvarez, Rivas-Lasarte, Belarte, Pamies Besora, Solé-González, Fluvià-Brugues, Zegrí-Reiriz, López López, Brossa, Pirla, Mesado, Mirabet, Roig and Álvarez-García. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Cardiac remodeling
• dc.subject.keyword Heart failure
• dc.subject.keyword Sacubitril/valsartan
• dc.subject.keyword Score
• dc.subject.keyword Super-response
• dc.title A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion