ACC/AHA/HFSA: Updated Guidelines for Treating Heart Failure

The American College of Cardiology (ACC), American Heart Association (AHA), and Heart Failure Society of America (HFSA) have updated their guidelines on treating heart failure.

The guidelines are updated annually to improve patient care by incorporating the evolving evidence, including new study results, medications, and devices.
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The ACC/AHA/HFSA Task Force on Clinical Practice Guidelines surveyed the available evidence and assessed its quality. They then categorized each recommendation as strong, moderate, or weak based on its benefits and risks.

The new recommendations include using 2 medications to complement established pharmacologic and device-based therapies.

An angiotensin receptor–neprilysin inhibitor (ARNI) (valsartan/sacubitril) or angiotensin-converting-enzyme  inhibitor (ACEI) should be used for patients with stage C heart failure with reduced ejection fraction. An ARNI should not be coadministered with an ACEI in patients with an angioedema history.

Furthermore, ivabradine, a sinoatrial node modulator, may help to reduce hospitalizations in patients with symptomatic stable chronic heart failure with reduced ejection fraction who are taking a maximum tolerated dose of a β-blocker or have a resting heart rate of 70 beats/min or more.

 “Several critical questions remain unanswered, and further experience in both ongoing trials and clinical therapeutics may require modification of these initial recommendations,” the task force concluded.

—Amanda Balbi

Reference:

Yancy CW, Jessup M, Bozkhurt B, et al. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA guideline for the management of heart failure [published online May 20, 2016]. Circulation. doi:10.1161/CIR.0000000000000435.