A Simple Score to Identify Super-Responders to Sacubitril/Valsartan in Ambulatory Patients With Heart Failure
| Autor: | Mercedes Rivas-Lasarte, Nuria Mesado, Jesús Álvarez-García, Isabel Zegrí-Reiriz, Carles Moliner-Abós, Diana Mojón Álvarez, V. Brossa, L. Lopez, Sonia Mirabet, Eduard Solé-González, Eulalia Roig, Paula Fluvià-Brugues, Julia Pamies Besora, Maria Jose Pirla, Laia Carla Belarte |
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| Přispěvatelé: | 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 |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Physiology heart failure Heart failure Logistic regression valsartan Sacubitril lcsh:Physiology Physiology (medical) Internal medicine Medicine score Sinus rhythm Sacubitril/valsartan sacubitril Cardiac remodeling Original Research Ejection fraction lcsh:QP1-981 business.industry Score super-response medicine.disease Valsartan sacubitril/valsartan Ambulatory Cardiology cardiac remodeling business Super-response Sacubitril Valsartan medicine.drug |
| Zdroj: | Frontiers in Physiology, Vol 12 (2021) Frontiers in Physiology Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 1664-042X |
| DOI: | 10.3389/fphys.2021.642117/full |
| Popis: | IntroductionSacubitril/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.MethodsThis 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.ResultsOut 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- (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.ConclusionOne-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. |
| Databáze: | OpenAIRE |
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