Thread by @ACCinTouch

Check out Top 10🔑points from the 🆕ACC/@American_Heart/@HFSA Guideline for the Management of #HeartFailure #CardioTwitter #ClinicalGuidelines #ACC22

🧵Key Points👇

1⃣ Guideline-directed medical therapy for #HeartFailure w/ reduced ejection fraction #HFrEF now incorporates four medication classes that include #SGLT2i. #ClinicalGuidelines

2⃣ #SGLT2i have a Class of Recommendation 2a in #HFmrEF. Weaker recommendations (COR 2b) are made for ARNi, ACEi, ARB, MRA & beta blockers in this population. #ClinicalGuidelines

3⃣New recommendations for #HFpEF are made for #SGLT2i, MRAs & ARNi.
Previous recommendations have been renewed:
✔️Tx of hypertension & AF
✔️Use of ARB
✔️ Avoiding routine use of nitrates or phosphodiesterase-5 inhibitors #ClinicalGuidelines

4⃣Improved LVEF is used to refer to those patients w/ previous #HFrEF who now have an LVEF >40%. These patients should continue their HFrEF treatment. #ClinicalGuidelines

5⃣Value statements were created for select reccs where high-quality, cost-effectiveness studies of the intervention have been published. High-value therapies: ARNi, ACEi, ARB, beta blocker, MRA, implantable cardioverter-defibrillator & cardiac resynchronization therapy.

6⃣ Amyloid heart disease has new recommendations for tx including screening for serum & urine monoclonal light chains, bone scintigraphy, genetic sequencing, tetramer stabilizer therapy & anticoagulation.

7⃣ Evidence supporting increased filling pressures is important for the diagnosis of #HeartFailure if the LVEF is >40%. Evidence for increased filling pressures can be obtained from noninvasive or invasive testing. #ClinicalGuidelines

8⃣ Patients with advanced #HeartFailure should be referred to a team specializing in HF. A HF specialty team reviews HF management, assesses suitability for advanced therapies & uses palliative care including palliative inotropes. #ClinicalGuidelines

9⃣ Primary prevention is important for those at risk for #HeartFailure (stage A) or pre-HF (stage B). Stages of Heart Failure were revised to emphasize the new terminologies of “at-risk for HF” for stage A & “pre-HF” for stage B. #cvPrev #ClinicalGuidelines

🔟 Specific-treatment recommendations are provided for patients w/ #HeartFailure & certain comorbidities, like iron deficiency, anemia, #hypertension, sleep disorders, type 2 #diabetes, #AFib, #CAD & malignancy.

More➡️ bit.ly/3IZLTnO #ClinicalGuidelines @JACCJournals