PARAGON-HF Response Score Calculator
- PARAGON-HF Response Score: Explanation and Clinical Context
The PARAGON-HF Response Score is an exploratory model derived from the PARAGON-HF trial, developed to identify patients with heart failure with preserved ejection fraction (HFpEF) who are most likely to experience clinical and biomarker improvement with sacubitril/valsartan therapy.
This score integrates demographic and clinical parameters — including age, sex, LVEF, kidney function, systolic blood pressure, body mass index, diabetes, atrial fibrillation, and NT-proBNP level — to estimate the probability of a favorable response defined as a ≥15% reduction in NT-proBNP or ≥5-point improvement in KCCQ score at 16 weeks.
Patients who were younger, female, had lower ejection fraction (closer to 45%), lower systolic blood pressure, and without atrial fibrillation or diabetes were more likely to show benefit. Conversely, patients with higher EF, long-standing AF, or advanced renal dysfunction had a lower response probability.
The model serves as a guide for personalized therapy selection in HFpEF, emphasizing heterogeneity of treatment effects across the spectrum of ejection fraction and comorbidity burden. It should be interpreted as a probabilistic aid rather than a strict clinical decision rule.
Reference:
Solomon SD, Rizkala AR, Gong J, et al. Angiotensin Receptor–Neprilysin Inhibition in Heart Failure With Preserved Ejection Fraction: Insights From the PARAGON-HF Trial. Circulation. 2021;143(5):438–448. doi:10.1161/CIRCULATIONAHA.120.050646
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