A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure
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...
| Autores: | , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2021 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:10230/47878 |
| Acceso en línea: | http://hdl.handle.net/10230/47878 http://dx.doi.org/10.3389/fphys.2021.642117 |
| Access Level: | acceso abierto |
| Palabra clave: | Cardiac remodeling Heart failure Sacubitril/valsartan Score Super-response |
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A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failureMoliner Abós, CarlesMojón Álvarez, DianaRivas-Lasarte, MercedesBelarte Tornero, Laia CarlaPamies Besora, JuliaSolé-González, EduardFluvià Brugues, PaulaZegrí Reiriz, IsabelLópez-López, LauraBrossa, VicensPirla, María J.Mesado, NuriaMirabet, SoniaRoig, EulàliaÁlvarez-García, JesusCardiac remodelingHeart failureSacubitril/valsartanScoreSuper-responseIntroduction: 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.Frontiers202120212021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/47878http://dx.doi.org/10.3389/fphys.2021.642117reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésFront Physiol. 2021;12:642117© 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.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/478782026-05-29T05:05:01Z |
| dc.title.none.fl_str_mv |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure |
| title |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure |
| spellingShingle |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure Moliner Abós, Carles Cardiac remodeling Heart failure Sacubitril/valsartan Score Super-response |
| title_short |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure |
| title_full |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure |
| title_fullStr |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure |
| title_full_unstemmed |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure |
| title_sort |
A simple score to identify super-responders to sacubitril/valsartan in ambulatory patients with heart failure |
| dc.creator.none.fl_str_mv |
Moliner Abós, Carles Mojón Álvarez, Diana Rivas-Lasarte, Mercedes Belarte Tornero, Laia Carla Pamies Besora, Julia Solé-González, Eduard Fluvià Brugues, Paula Zegrí Reiriz, Isabel López-López, Laura Brossa, Vicens Pirla, María J. Mesado, Nuria Mirabet, Sonia Roig, Eulàlia Álvarez-García, Jesus |
| author |
Moliner Abós, Carles |
| author_facet |
Moliner Abós, Carles Mojón Álvarez, Diana Rivas-Lasarte, Mercedes Belarte Tornero, Laia Carla Pamies Besora, Julia Solé-González, Eduard Fluvià Brugues, Paula Zegrí Reiriz, Isabel López-López, Laura Brossa, Vicens Pirla, María J. Mesado, Nuria Mirabet, Sonia Roig, Eulàlia Álvarez-García, Jesus |
| author_role |
author |
| author2 |
Mojón Álvarez, Diana Rivas-Lasarte, Mercedes Belarte Tornero, Laia Carla Pamies Besora, Julia Solé-González, Eduard Fluvià Brugues, Paula Zegrí Reiriz, Isabel López-López, Laura Brossa, Vicens Pirla, María J. Mesado, Nuria Mirabet, Sonia Roig, Eulàlia Álvarez-García, Jesus |
| author2_role |
author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Cardiac remodeling Heart failure Sacubitril/valsartan Score Super-response |
| topic |
Cardiac remodeling Heart failure Sacubitril/valsartan Score Super-response |
| description |
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. |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021 2021 2021 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10230/47878 http://dx.doi.org/10.3389/fphys.2021.642117 |
| url |
http://hdl.handle.net/10230/47878 http://dx.doi.org/10.3389/fphys.2021.642117 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Front Physiol. 2021;12:642117 |
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http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
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http://creativecommons.org/licenses/by/4.0/ |
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openAccess |
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application/pdf application/pdf |
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Frontiers |
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Frontiers |
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reponame:Recercat. Dipósit de la Recerca de Catalunya instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
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