❤️ 2023 Heart Failure Guideline Highlights & Updates
A Twitter thread 🧵
A Twitter thread 🧵
Based on guidelines by the European Society of Cardiology (ESC 2023), the European Society of Hypertension (ESH 2023), and the Heart Failure Society of America (HFSA/AHA/ACC 2022), among others.
1️⃣ Initiating ACEIs/ARBs & More in HFrEF
Initiate ACEIs/ARBs/angiotensin receptor-neprilysin inhibitors and mineralocorticoid receptor antagonists in all patients with HFrEF. (A)
Initiate ACEIs/ARBs/angiotensin receptor-neprilysin inhibitors and mineralocorticoid receptor antagonists in all patients with HFrEF. (A)
2️⃣ African American NYHA III-IV HFrEF Patients
Initiate a combination of hydralazine and isosorbide dinitrate to improve symptoms & reduce morbidity & mortality in patients self-identified as African American with NYHA class III-IV HFrEF receiving optimal medical therapy. (A)
Initiate a combination of hydralazine and isosorbide dinitrate to improve symptoms & reduce morbidity & mortality in patients self-identified as African American with NYHA class III-IV HFrEF receiving optimal medical therapy. (A)
3️⃣ Choice of Beta Blockers in HFrEF
Initiate one of the three beta blockers proven to reduce mortality (bisoprolol, carvedilol, sustained-release metoprolol succinate) to reduce mortality and hospitalizations in patients with HFrEF with current or previous symptoms. (A)
Initiate one of the three beta blockers proven to reduce mortality (bisoprolol, carvedilol, sustained-release metoprolol succinate) to reduce mortality and hospitalizations in patients with HFrEF with current or previous symptoms. (A)
4️⃣ SGLT-2 Inhibitors for All HFrEF Patients
Initiate SGLT-2 inhibitors in all patients with HFrEF. (A)
Initiate SGLT-2 inhibitors in all patients with HFrEF. (A)
5️⃣ SGLT-2 Inhibitors in HF with Preserved Ejection Fraction
Initiate SGLT-2 inhibitors (dapagliflozin or empagliflozin) to reduce the risk of HF hospitalization or cardiovascular death in patients with HF with preserved ejection fraction. (A)
Initiate SGLT-2 inhibitors (dapagliflozin or empagliflozin) to reduce the risk of HF hospitalization or cardiovascular death in patients with HF with preserved ejection fraction. (A)
6️⃣ Antihypertensive Drugs in HF with Preserved Ejection Fraction
Use all major antihypertensive drug classes (ACEIs or ARBs, β-blockers, CCBs, and thiazide/thiazide-like diuretics) for the treatment of hypertension in patients with HF with preserved ejection fraction. (A)
Use all major antihypertensive drug classes (ACEIs or ARBs, β-blockers, CCBs, and thiazide/thiazide-like diuretics) for the treatment of hypertension in patients with HF with preserved ejection fraction. (A)
7️⃣ IV Iron Supplementation
Initiate IV iron supplementation to alleviate HF symptoms and improve quality of life in symptomatic patients with HFrEF or HF with mildly reduced ejection fraction and iron deficiency. (A)
Initiate IV iron supplementation to alleviate HF symptoms and improve quality of life in symptomatic patients with HFrEF or HF with mildly reduced ejection fraction and iron deficiency. (A)
8️⃣ Finerenone for T2DM and CKD Patients
Initiate finerenone to reduce the risk of HF hospitalization in patients with T2DM and CKD. (A)
Initiate finerenone to reduce the risk of HF hospitalization in patients with T2DM and CKD. (A)
9️⃣ Post-Hospitalization Strategy
Implement an intensive strategy of initiation & rapid up-titration of evidence-based tx before discharge and during frequent and careful follow-up visits in first 6 wks following hosp. for HF to ↓ the risk of HF rehospitalization or death. (B)
Implement an intensive strategy of initiation & rapid up-titration of evidence-based tx before discharge and during frequent and careful follow-up visits in first 6 wks following hosp. for HF to ↓ the risk of HF rehospitalization or death. (B)
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#HeartFailure #Cardiology #ESC2023 #ESH2023 #HFSA #AHA #ACC
And weekly guideline summaries like this on the TLDR Primary Care newsletter 👉newsletter.pathway.md
#HeartFailure #Cardiology #ESC2023 #ESH2023 #HFSA #AHA #ACC
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