News | Heart Failure | May 23, 2016

Societies Release Guideline Update for Heart Failure Therapies

Document addresses use of two new heart failure medications

May 23, 2016 — In a guideline update published last week, the American College of Cardiology, American Heart Association and Heart Failure Society of America detail the groups’ recommendations for the use of two new heart failure medications.

This update to the 2013 ACCF/AHA Guideline for the Management of Heart Failure includes the addition of an angiotensin receptor-neprilysin inhibitor (ARNI) (valsartan/sacubitril), and a sinoatrial node modulator (ivabradine) to the list of treatment options for Stage C heart failure patients with a reduced ejection fraction. The previously determined drug options for these patients include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), aldosterone antagonists, beta blockers, the combination of isosorbide dinitrate and hydralazine, and diuretics. The goal of all of these medications is to relax blood vessels, reduce (biological) stress and improve the function of the heart.

“Not every patient is a good candidate for every drug; these guidelines can help physicians decide who best fits which treatment,” said Clyde W. Yancy, MD, MSc, MACC, FAHA, FHFSA, professor of medicine and chief of cardiology at the Northwestern University Feinberg School of Medicine and chair of the writing committee. “This document details the benefits and risks of these new therapies so that patients at high risk can be directed towards alternative therapies.”

According to the new recommendations, a therapeutic regimen of an ACE inhibitor or ARB or ARNI along with a beta blocker and an aldosterone antagonist is the new recommended therapy for patients with chronic symptomatic heart failure with reduced ejection fraction. ARNIs should replace ACE inhibitors (or ARBs) when stable patients with mild-to-moderate heart failure on these therapies have an adequate blood pressure and are otherwise tolerating standard therapies well. ARNIs, however, should not be used with an ACE inhibitor and should not be used by patients with a history of angioedema.

Ivabradine may be beneficial in reducing heart failure hospitalizations in patients with symptomatic stable chronic heart failure with reduced ejection fraction who are receiving guideline-directed evaluation and management, including a beta blocker at a maximum tolerated dose, and who are in sinus rhythm with a heart rate of 70 beats per minute or greater at rest.

“Treatment options for patients with heart failure have expanded considerably. There is more hope than ever before for patients with heart failure. These guideline recommendations will serve as a tool to guide the choice of therapy and in turn improve outcomes,” said Mariell Jessup, M.D., FACC, FAHA, professor of medicine at the University of Pennsylvania School of Medicine and vice chair of the writing committee.

While a full update to the heart failure guideline is being developed, these recommendations are being released early to coincide with the release of the 2016 European Society of Cardiology Guideline on the Diagnosis and Treatment of Acute and Chronic Heart Failure. The recommendations are being released concurrently in order to minimize confusion and improve the care of patients with heart failure.

The guideline published online in the Journal of the American College of Cardiology, Circulation and the Journal of Cardiac Failure.

For more information: www.content.onlinejacc.org, www.circ.ahajournals.org, www.onlinejcf.com

Related Content

EMPRISE Study Shows Empagliflozin Reduces Heart Failure Hospitalization with new data presented at AHA 2018. #AHA18 #AHA2018
News | Heart Failure | November 07, 2018
November 6, 2018 – Initial results from the real-world EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) s
Acute Heart Failure Mortality, Rehospitalizations Reduced With Blood Volume Measurement
News | Heart Failure | November 02, 2018
In a new study, acute heart failure patients who received individualized treatment by blood volume measurement with the...
Daxor Corp. Collaborating With CHF Solutions on Heart Failure Fluid Overload Management

CHF Solutions' Aquadex FlexFlow System

News | Heart Failure | November 01, 2018
November 1, 2018 — Daxor Corp.
NHLBI Pauses CONCERT-HF Heart Failure Trial
News | Heart Failure | October 29, 2018
The National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, is pausing the...
A patient who received the HeartMate III LVAD system showing off his external battery pack. He served as a patient ambassador in the Abbott booth at ACC 2018. The HeartMate III, with its magnetic levitated pump, showed a big reduction in clotting over previous LVADs in a key late-breaking trial at ACC earlier this year.

A patient who received the HeartMate III LVAD system showing off his external battery pack. He served as a patient ambassador in the Abbott booth at ACC 2018. The HeartMate III, with its magnetic levitated pump, showed a big reduction in clotting over previous LVADs in a key late-breaking trial at ACC earlier this year.

Feature | Heart Failure | October 19, 2018
October 19, 2018 — Abbott announced today that the HeartMate 3 Left Ventricular Assist Device (LVAD) has received U.S
Ohio State First in U.S. to Test Shunt Device for Heart Failure
News | Heart Failure | October 04, 2018
The Ohio State University Wexner Medical Center is first in the country to test a new medical device designed to help...
Mitral Regurgitation Volume Reduced at One Year in REDUCE FMR Trial
News | Heart Failure | September 28, 2018
Heart failure patients who received the Carillon Mitral Contour System in the REDUCE FMR clinical trial showed a...
Cardiac Dimensions Randomizes First Patient in CARILLON Trial of Mitral Contour System
News | Heart Failure | September 20, 2018
Cardiac Dimensions announced the company has randomized its first patient in the CARILLON Pivotal Trial.
Overlay Init