Core Concepts
Optimizing heart failure treatment for better outcomes.
Abstract
The American College of Cardiology released an updated consensus decision pathway for treating heart failure with reduced ejection fraction (HFrEF). The document aims to provide practical guidance for frontline clinicians, incorporating evidence from the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. It addresses key issues in HFrEF treatment, emphasizing the importance of early initiation and adherence to evidence-based therapies. The guidance focuses on practical tips, tables, and figures to streamline patient management and improve outcomes.
Key Highlights:
New Decision Pathway for HFrEF treatment by ACC.
Emphasis on practicality in delivering care.
Guidance on introducing evidence-based therapies.
Importance of adherence and overcoming treatment barriers.
Recommendations for special cohorts and palliative care.
Updates on key areas of advice for heart failure treatment.
Focus on Valsartan/Sacubitril and SGLT inhibitors.
Rapid initiation of the four pillars of therapy.
Considerations for practical barriers in treatment.
Advocacy for the use of digital tools in care delivery.
Team approach for managing treatment plans.
Stats
"It is now clear that this agent is superior to ACE-inhibitors or angiotensin receptor blockers in terms of reducing heart failure hospitalization and death."
"Sotagliflozin is a newer agent, which inhibits both SGLT1 and SGLT2, and it turns out that inhibiting both are beneficial in heart failure."
"Four-class medication initiation reduced the hazard of cardiovascular death or hospital admission for heart failure significantly."
Quotes
"While the AHA/ACC/HFSA Guidelines are wonderful in that they collate all the latest scientific evidence, they don't speak as much to the practicalities of delivering the care."
"The more quickly we can get patients on all four of these drug classes and escalate to target doses or maximally tolerated doses ideally within 3 months, the better the outcome."