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Guidelines for treating heart failure

Michelle M Kittleson1

  • 1Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Trends in Cardiovascular Medicine
|October 23, 2024
PubMed

Insights

Optimal medical therapy for heart failure with reduced ejection fraction includes four key drug classes. For heart failure with preserved ejection fraction, sodium-glucose cotransporter-2 inhibitors are recommended.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Heart failure (HF) management has evolved with new evidence.
  • Guideline-directed medical therapy (GDMT) is crucial for HF outcomes.

Purpose of the Study:

  • To review evidence supporting current HF guidelines.
  • To discuss the impact of recent trials on HF management.
  • To outline strategies for implementing GDMT in clinical practice.

Main Methods:

  • Literature review of guideline recommendations.
  • Analysis of recent clinical trials in heart failure.
  • Synthesis of evidence for GDMT implementation.

Main Results:

  • GDMT for HF with reduced ejection fraction (HFrEF) includes ARNIs, beta-blockers, MRAs, and SGLT2 inhibitors.
  • GDMT for HF with preserved ejection fraction (HFpEF) emphasizes SGLT2 inhibitors, with MRAs and GLP-1 RAs showing promise.
  • Newer trials are refining treatment paradigms for both HFrEF and HFpEF.

Conclusions:

  • Current GDMT effectively manages HFrEF.
  • SGLT2 inhibitors are foundational for HFpEF, with other agents under investigation.
  • Evidence-based strategies are essential for optimizing HF patient care.

Keywords:
Guideline-directed medical therapyHeart failure with preserved ejection fractionHeart failure with reduced ejection fraction

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