Updated ACC/AHA Guideline for Management of Heart Failure Released
The ACC Foundation (ACCF) and American Heart Association (AHA) on June 5 jointly released an expanded clinical practice guideline for the management of patients with Heart Failure (HF) .
Designed to assist clinicians in selecting the best management strategy for individual patients, the guideline updates definitions and classifications for HF and increases emphasis on patient-centric outcomes such as quality of life, shared decision making, care coordination, transitions and palliative care.
Of note, the guideline provides a more focused approach on dilated cardiomyopathies and the appropriate evaluation including family and genetic screening/counseling, expanded use of aldosterone antagonism for HF, better descriptions and a more thorough analysis of HF with preserved ejection fraction, more discriminate use of cardiac resynchronization therapy, recommendations for advanced HF therapies that prompt appropriate use of ventricular assist technologies, and more. The document also discusses greater adherence to performance measures and quality measures, with timely recommendations to reduce readmissions.
In addition, it is the first ACC/AHA guideline to include the new designation for optimal treatment, termed "guideline-directed medical therapy" (GDMT). The new GDMT designation allows clinicians to easily determine the specific course of care deemed most important in the management of HF.
The authors also discuss the current gaps in knowledge in HF care and note that "more successful risk modification, sophisticated screening, perhaps using specific-omics technologies, or effective treatment interventions that reduce the progression from stage A to stage B is an urgent need."
According to Clyde W. Yancy, MD, MSc, FACC, chair of the writing committee and professor of medicine and chief of cardiology at Northwestern University Feinberg School of Medicine, the importance of the guideline cannot be underestimated. "Available data are clear that adherence to evidence-based guideline-directed care for HF improves outcomes," he said. "The emphasis in this guideline on quality of care and performance improvement is well-placed and merits a firm embrace by those who see and treat patients with HF."
The document was developed in collaboration with the American Academy of Family Physicians, American College of Chest Physicians, Heart Rhythm Society, and the International Society for Heart and Lung Transplantation. A full text of the report will be published in the Journal of the American College of Cardiology.
Keywords: Palliative Care, Mineralocorticoid Receptor Antagonists, Heart Failure, Physicians, Family, Genetic Testing, Cardiomyopathy, Dilated, Cardiac Resynchronization Therapy
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