Updated Guidelines on Heart Failure Treatment and Management Are Published

The American Heart Association (AHA), the American College of Cardiology (ACC), and the Heart Failure Society of America (HFSA) have updated their joint clinical practice guidelines on the treatment and management of heart failure.

The guidelines come as an update to the groups’ prior recommendations on heart failure management released in 2013 and 2017. In the latest update, a literature review was conducted from May 2020 to December 2020, with consideration of studies published through September 2021.

Among the recommendations:

• Guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) now includes 4 medication classes with the addition of sodium-glucose cotransporter-2 inhibitors (SGLT2i).
• SGLT2i are also now recommended for use in patients with heart failure with mildly reduced ejection fraction (HFmrEF) and those with heart failure with preserved ejection fraction (HFpEF).
• Patients with heart failure and certain comorbidities have specific treatment recommendations. These comorbidities include iron deficiency, anemia, hypertension, sleep disorders, type 2 diabetes, atrial fibrillation, coronary artery disease, and malignancy.

“The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients’ interests,” the writing committee concluded. “Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.”

—Leigh Precopio

Reference:

Heidenreich PA, Bozkurt B, Aguilar D, at al; American College of Cardiology/American Heart Association Writing Committee. 2022 AHA/ACC/HFSA guideline for the management of heart failure. J Am Coll Cardiol. Published online April 1, 2022. doi:10.1016/j.jacc.2021.12.012