MAGGIC Risk Score for Heart Failure
Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score predicts 1-year and 3-year all-cause mortality in chronic heart failure.
Score interpretation
MAGGIC ≤ 12: Low mortality risk. 1-year mortality ~2–5%.
→ Optimise guideline-directed medical therapy (GDMT): ACEi/ARB/ARNI + beta-blocker + MRA + SGLT2i for HFrEF. Annual HF clinic review. Exercise-based cardiac rehabilitation.
MAGGIC 13–20: Intermediate mortality risk. 1-year mortality ~10–20%.
→ Intensive GDMT optimisation. Consider ICD if LVEF ≤ 35% on optimal therapy ≥ 3 months. CRT if LBBB + QRS ≥ 150ms + LVEF ≤ 35%. 3-monthly HF clinic review. Dietitian input. Implantable loop recorder if arrhythmia suspected.
MAGGIC > 20: High mortality risk. 1-year mortality > 30%.
→ Advanced HF team referral. Consider LVAD or heart transplant assessment if eligible. Maximise GDMT. Early palliative care integration. Advance care planning. Consider hospice referral if end-stage symptoms despite optimal therapy.
Interpretation bands for the MAGGIC. Apply clinical judgement and local guidance.
References
- Pocock SJ et al. Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. Eur Heart J. 2013.
Related
Curated clinical cross-links plus same-class fallbacks.
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.