JACC publishes expert consensus document to guide clinicians’ treatment of HFrEF

The American College of Cardiology (ACC) published on Jan. 8 an expert consensus decision pathway for the treatment of heart failure with reduced ejection fraction (HFrEF).

An update on the 2013 heart failure guidelines released jointly by the ACC and the American Heart Association, the new decision pathway aims to guide clinicians through 10 critical issues:

1. Initiating, adding or switching therapy to new evidence-based guideline-directed treatments for HFrEF.
2. Achieving optimal therapy given multiple drugs for HF including augmented clinical assessment that may trigger additional changes in guideline-directed therapy (e.g., imaging data, biomarkers, and filling pressures).
3. When to refer to a heart failure specialist.
4. Addressing care coordination challenges.
5. Improving adherence.
6. Addressing the needs of specific patient cohorts.
7. Managing patients’ cost of care.
8. Managing the increasing complexity of heart failure.
9. Managing common comorbidities.
10. Integrating palliative care and the transition to hospice care.

“The care of patients with HF is more involved than ever,” the 15 experts wrote in the Journal of the American College of Cardiology. “Current care for the patient with HF with reduced ejection fraction (EF) includes no fewer than 7 evidence-based medications, 3 evidence-based device strategies, and a number of recommend processes of care. The opportunity to change the natural history of HF with reduced EF has never been better, but with more choices comes greater complexity. …

“The treatment of HF with reduced EF can feel overwhelming, and many opportunities to improve patient outcomes are being missed; hopefully, this Expert Consensus Decision Pathway may streamline care to realize best possible patient outcomes in HF.”

Read the full document below: