PARADIGM-HF Responder Index (AWARD-Class) Calculator

Female?

Aldosterone (MRA) naive? (Not previously treated with spironolactone/eplerenone)

Diuretics naive? (No chronic loop/thiazide diuretics prior)

NYHA class I–II?

Heart-failure admission in last 12 months?

Sinus rhythm? (ECG: sinus vs AF/other)

AWARD-Class / PARADIGM-HF Responder context and interpretation
The AWARD-Class score (derived from a two-center real-world cohort) is an easy-to-calculate index intended to predict a 1-year “super-response” to sacubitril/valsartan, defined in the derivation study as absence of HF admission/transplant/death plus either ≥50% NT-proBNP reduction and/or ≥10-point increase in LVEF. The score uses six routinely available clinical variables (MRA use, sex, recent HF admission, ECG rhythm, diuretics use, and NYHA class) and maps the summed points to three probability groups (low, intermediate, high). Use this tool as an adjunct to clinical judgment — it was derived from an observational cohort and has not replaced randomized evidence.

Reference: Moliner-Abós C, Rivas-Lasarte M, Pamies Besora J, et al. “A Simple Score to Identify Super-Responders to Sacubitril/Valsartan in Ambulatory Patients With Heart Failure.” Cardiovasc Drugs Ther. 2021. (AWARD-Class score table and categories).
For original randomized evidence on sacubitril/valsartan (PARADIGM-HF), see McMurray JJV et al., NEJM 2014.

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