A Simple Score to Identify Super-Responders to Sacubitril/Valsartan in Ambulatory Patients With Heart Failure

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 predicti...

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Detalles Bibliográficos
Autores: Moliner-Abós, Carles|||0000-0002-9264-5804, Mojón Álvarez, Diana, Rivas-Lasarte, Mercedes|||0000-0002-8704-3104, Belarte Tornero, Laia Carla|||0000-0003-2774-1290, Pamies Besora, Julia, Solé González, Eduard|||0000-0002-5727-9925, Fluvià, Paula|||0000-0002-4683-9122, Zegrí-Reiriz, Isabel|||0000-0001-9742-8537, López López, Laura|||0000-0002-8653-6206, Brossa Loidi, Vicens|||0000-0003-0403-6425, Pirla, Maria José, Mesado, Nuria, Mirabet Pérez, Sonia|||0000-0001-5955-2748, Roig, Eulàlia|||0000-0002-3421-4985, Alvarez-Garcia, Jesus|||0000-0002-2015-6446
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:237598
Acceso en línea:https://ddd.uab.cat/record/237598
https://dx.doi.org/urn:doi:10.3389/fphys.2021.642117
Access Level:acceso abierto
Palabra clave:Sacubitril/valsartan
Heart failure
Super-response
Score
Cardiac remodeling
Descripción
Sumario: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. 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. 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 (.

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