HF guidelines Flashcards
TAFAMIDIS
is recommended in patients with genetic testing proven hTTR-CA, wtTTR-CA who are NYHA I or II to reduce symptoms, CV hospitalization, motality
CLASS I
Right heart catheterization should be considered in patients where HF is thought to be due to constrictive pericarditis, restrictive cardiomyopathy, congenital heart disease, and high output states.
class IIa
Right heart catheterization may be considered in selected patients with HFpEF to confirm the diagnosis.
CLASS IIb
Dapagliflozin or empagliflozin are recommended for patients with HFrEF to reduce the risk of HF hospitalization and death.
CLASS I
Vericiguat
NYHA class II-IV who had worsening HF depsite treatment with 4 pillars
class IIb
HFmrEF
ACEI, ARB, BB, MRA, ENTRESTO
class IIb
Influenza and pneumococcal vaccinations should be considered in order to prevent HF hospitalizations.
class IIa
It is recommended that patients hospitalized for HF be carefully evaluated to exclude persistent signs of congestion before discharge and to optimize oral treatment.
class I
it is recommended that evidence-based oral medical treatment be administered before discharge.
class I
An early follow-up visit is recommended at 12 weeks after discharge to assess signs of congestion, drug tolerance, and start and/or uptitrate evidence-based therapy.
class I
Long-term treatment with an oral anticoagulant should be considered for stroke prevention in AF patients with a CHA2DS2-VASc score of 1 in men or 2 in women.
class IIa
revascularization in CCS and HF
CABG should be considered as the first-choice revascularization strategy, in patients suitable for surgery, especially if they have diabetes and for those with multivessel disease.
class IIa
In LVAD candidates needing coronary revascularization, CABG should be avoided, if possible.
class IIa
PCI may be considered as alternative to CABG, based on Heart Team evaluation, considering coronary anatomy, comorbidities, and surgical risk.
class IIb
Coronary revascularization may be considered to improve outcomes in patients with HFrEF, CCS, and coronary anatomy suitable for revascularization, after careful evaluation of the individual risk to benefit ratio, including coronary anatomy (i.e. proximal stenosis >90% of large vessels, stenosis of left main or proximal LAD), comorbidities, life expectancy, and patient’s perspectives
class IIb
Percutaneous edge-to-edge mitral valve repair should be considered in carefully selected patients with secondary mitral regurgitation, not eligible for surgery and not needing coronary revascularization, who are symptomatic despite OMT and who fulfil criteria to achieve a reduction in HF hospitalizations.
class IIa
Percutaneous edge-to-edge mitral valve repair may be considered to improve symptoms in carefully selected patients with secondary mitral regurgitation, not eligible for surgery and not needing coronary revascularization, who are highly symptomatic despite OMT and who do not fulfil criteria for reducing HF hospitalization.
class IIb
SGLT in HF and DM
recommended for pts with T2DM at risk of CV events
and for pts with HF and T2DM
class I
DPP4 saxagliptin
class III in HF
IV iron
if EF 50% and ferritin less than 100 or 100-299 with TSAT less than 20%
EPO in HF
Class III
cancer pts on antrhracycline
ACEI and BB (carvedilol) if developed LV systolic dysfunction (10% dec. in EF to a value lower than 50%)
diagnostic algorithm of HF 1
risk factors + sign and symptoms + ECG
diagnostic algorithm HF 2
NT pro BNP 125
BNP 35
in AF X3
NT pro BNP 365
BNP 105