MAGGIC risk score and drug-related adverse events of sacubitril/valsartan: Insights from the REVIEW-HF registry

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-05-10 DOI:10.1016/j.ijcha.2025.101702

Daiki Akagaki , Tatsuhiro Shibata , Kodai Shibao , Koshiro Kanaoka , Takahito Nasu , Shunsuke Ishii , Nobuyuki Kagiyama , Keisuke Kida , Wataru Fujimoto , Atsushi Kikuchi , Takeshi Ijichi , Yoshihiro Fukumoto , Shingo Matsumoto

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引用次数: 0

Abstract

Background

Although the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score is a validated mortality risk tool in heart failure (HF), its utility in assessing drug-related adverse events (DAEs) associated with sacubitril/valsartan initiation remains unclear. This study evaluated the association between the MAGGIC risk score and DAEs related to sacubitril/valsartan initiation in a Japanese multicenter cohort.

Methods

We analyzed 787 patients with HF initiated on sacubitril/valsartan 100 mg/day between August 2020 and August 2021. Patients were stratified into tertiles based on MAGGIC risk scores. The primary outcome was DAEs within 90 days of initiation, defined as hypotension, hyperkalemia, renal events, or angioedema. Secondary outcomes included drug discontinuation and clinical outcomes.

Results

DAEs occurred in 22.7 % patients. Higher MAGGIC risk scores were significantly associated with increased DAEs (adjusted odds ratio [OR] for highest vs. lowest tertile: 2.64, 95 % confidence interval [CI]: 1.66–4.25, p for trend < 0.001) and sacubitril/valsartan discontinuation (21.3 % of patients; adjusted OR for highest vs. lowest tertile: 2.68, 95 % CI: 1.69–4.32, p for trend < 0.001). Time-dependent Cox proportional hazard analyses revealed that the association between DAEs and clinical outcomes varied across the MAGGIC risk score tertiles, with significant interactions between the composite outcome and hospitalization for HF, particularly in lower-risk groups.

Conclusions

The MAGGIC risk score was associated with DAEs risk following sacubitril/valsartan initiation in patients with HF. The impact of DAEs on outcomes varied across risk tertiles, suggesting potential utility for risk stratification and monitoring approaches in HF management.

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苏比里尔/缬沙坦的MAGGIC风险评分和药物相关不良事件：来自REVIEW-HF注册表的见解

背景：尽管全球慢性心力衰竭荟萃分析（MAGGIC）风险评分是心力衰竭（HF）的有效死亡率风险工具，但其在评估与沙比里尔/缬沙坦起始相关的药物相关不良事件（DAEs）方面的效用尚不清楚。本研究在日本多中心队列中评估了MAGGIC风险评分与沙比里尔/缬沙坦起始相关的DAEs之间的关系。方法分析2020年8月至2021年8月期间，787例HF患者开始服用苏比里尔/缬沙坦100mg /天。根据MAGGIC风险评分将患者分层。主要终点是起始90天内的DAEs，定义为低血压、高钾血症、肾脏事件或血管性水肿。次要结局包括停药和临床结局。结果daes发生率为22.7%。较高的MAGGIC风险评分与DAEs的增加显著相关(最高和最低分位数的调整优势比[OR]: 2.64, 95%可信区间[CI]: 1.66-4.25，趋势和lt的p；0.001)和停用苏比里尔/缬沙坦(21.3%；最高和最低胎位数的调整OR: 2.68, 95% CI: 1.69-4.32， p为趋势和lt；0.001)。时间相关的Cox比例风险分析显示，在MAGGIC风险评分中，DAEs与临床结果之间的关联各不相同，综合结果与HF住院之间存在显著的相互作用，特别是在低风险组中。结论：HF患者服用苏比里尔/缬沙坦后，MAGGIC风险评分与DAEs风险相关。DAEs对预后的影响因风险分类而异，这表明在心衰管理中存在风险分层和监测方法的潜在效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.