American English 3 Teachers.epub

This article is the authorized version of the following article published by a peer-reviewed journal: Fraleigh KJ, Conway RA, Pellico A, Paces M, Fontaine G, Djikeng G, McCullough TE. Heart failure expert panel: the fourth report of the ACCF/AHA focused update of the guidelines for the management of heart failure in adults. J Am Coll Cardiol. 2011 Oct 25;57(15):1457-1496. Copyright 2011, American College of Cardiology Foundation, American Heart Association. Reprinted by permission.

In May 2017, The ACC convened a panel of experts to develop updated guidelines on the role of HF pharmacotherapy for patients with stable symptomatic HF, including specifically patients with preserved EF. This document outlines the ACC’s updated recommendations on pharmacotherapy in patients with HF and acknowledges the advances made in randomized controlled trials (RCTs) since the 2006 ACCF/AHA guidelines published in the Journal of the American College of Cardiology. ⁴⁸³ In their work, Garg et al. found that outcomes for patients with HF and preserved EF are better with ACE inhibitor/angiotensin receptor blocker (ARB) compared with either a diuretic or ARB alone, with or without beta blocker therapy. ⁴⁸⁴ The authors suggest that the beneficial effects of this combination are at least partially independent of the HF medications used for both HF and coronary artery disease (CAD). ⁴⁸⁴ Moreover, despite the lack of effect for beta blocker monotherapy, results for patients with HF and reduced EF remain positive. This approach has the potential to decrease total mortality and HF-related costs.

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