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Management of Heart Failure

To identify the key insights or developments described in this article
1 Credit CME

Since the 2017 publication of the ACC/AHA/HFSA focused update of HF guidelines, multiple clinical trials have demonstrated the significant benefits of novel medical therapies for patients with HF across the spectrum of EF.14 The emergence of these therapies adds nuance and complexity to the care of patients with HF.

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Article Information

Corresponding Author: Adam S. Cifu, MD, University of Chicago, 5841 S Maryland Ave, MC 3051, Chicago, IL 60637 (adamcifu@uchicago.edu).

Published Online: September 15, 2022. doi:10.1001/jama.2022.16667

Correction: This article was corrected on January 17, 2023, to fix an incorrect term.

Conflict of Interest Disclosures: Dr Pinney reported receipt of personal fees from Abbott, CareDx, Medtronic, TransMedics, Valgen Medtech, Ancora Heart, and ADS and nonfinancial support from Procyrion. No other disclosures were reported.

References
1.
Packer  M , Anker  SD , Butler  J ,  et al.  Cardiovascular and renal outcomes with empagliflozin in heart failure.   N Engl J Med. 2020;383(15):1413-1424. PubMedGoogle ScholarCrossref
2.
Zannad  F , Ferreira  JP , Pocock  SJ ,  et al.  SGLT2 inhibitors in patients with heart failure with reduced ejection fraction.   Lancet. 2020;396(10254):819-829. doi:10.1016/S0140-6736(20)31824-9PubMedGoogle ScholarCrossref
3.
Anker  SD , Butler  J , Filippatos  G ,  et al.  Empagliflozin in heart failure with a preserved ejection fraction.   N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038PubMedGoogle ScholarCrossref
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McMurray  JJ , Packer  M , Desai  AS ,  et al.  Angiotensin-neprilysin inhibition versus enalapril in heart failure.   N Engl J Med. 2014;371(11):993-1004. doi:10.1056/NEJMoa1409077PubMedGoogle ScholarCrossref
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Heidenreich  PA , Bozkurt  B , Aguilar  D ,  et al.  2022 AHA/ACC/HFSA guideline for the management of heart failure.   J Am Coll Cardiol. 2022;79(17):e263-e421. doi:10.1016/j.jacc.2021.12.012PubMedGoogle ScholarCrossref
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McMurray  JJV , Solomon  SD , Inzucchi  SE ,  et al.  Dapagliflozin in patients with heart failure and reduced ejection fraction.   N Engl J Med. 2019;381(21):1995-2008. doi:10.1056/NEJMoa1911303PubMedGoogle ScholarCrossref
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Halliday  BP , Wassall  R , Lota  AS ,  et al.  Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF).   Lancet. 2019;393(10166):61-73. PubMedGoogle ScholarCrossref
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Bhagat  AA , Greene  SJ , Vaduganathan  M ,  et al.  Initiation, continuation, switching, and withdrawal of heart failure medical therapies during hospitalization.   JACC Heart Fail. 2019;7(1):1-12. doi:10.1016/j.jchf.2018.06.011PubMedGoogle ScholarCrossref
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Rao  VN , Murray  E , Butler  J ,  et al.  In-hospital initiation of sodium-glucose cotransporter-2 inhibitors for heart failure with reduced ejection fraction.   J Am Coll Cardiol. 2021;78(20):2004-2012. PubMedGoogle ScholarCrossref
10.
Yancy  CW , Jessup  M , Bozkurt  B ,  et al.  2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure.   J Am Coll Cardiol. 2017;70(6):776-803. doi:10.1016/j.jacc.2017.04.025PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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