Today, I review, link to, and excerpt from 2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. Thomas M Maddox, James L Januzzi Jr, Larry A Allen, Khadijah Breathett, Sara Brouse, Javed Butler, Leslie L Davis, Gregg C Fonarow, Nasrien E Ibrahim, JoAnn Lindenfeld, Frederick A Masoudi, Shweta R Motiwala, Estefania Oliveros, Mary Norine Walsh, Alan Wasserman, Clyde W Yancy, Quentin R Youmans. J Am Coll Cardiol. 2024 Apr 16;83(15):1444-1488. doi: 10.1016/j.jacc.2023.12.024. Epub 2024 Mar 8.
All that follows is from the above resource.
1. Introduction
The purpose of this document is to update the 2021 ECDP with further data from recent studies and to provide succinct, practical guidance for managing patients with HFrEF. The format of the 10 Pivotal Issues in the prior versions of this ECDP was preserved, and their associated treatment algorithms and tables have been updated to accommodate the evolving evidence. The Preface and Methods sections are accessible online in the Supplemental Appendix.
Ten Pivotal Issues in HFrEF
- 1.
How to initiate, add, or switch therapies with consideration of newer evidence-based guideline-directed treatments for HFrEF.
- 2.
How to achieve optimal therapy given multiple drugs for HF, including augmented clinical assessment (eg, imaging data, biomarkers, and filling pressures) that may trigger modifications in guideline-directed therapy.
- 3.
When to refer to an HF specialist.
- 4.
How to enhance care coordination.
- 5.
How to improve medication adherence.
- 6.
How to tailor treatment in specific patient cohorts: African-American patients, older adults, and patients with frailty.
- 7.
How to manage patients’ costs and increase access to HF medications.
- 8.
How to manage the increasing complexity of HF.
- 9.
How to manage common comorbidities.
- 10.
How to integrate palliative care and the transition to hospice care.
