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JAAPA. 2019 Jan;32(1):11-15. doi: 10.1097/01.JAA.0000550282.19722.93.

No longer failing to treat heart failure: A guideline update review.

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1
Jonathan Parch practices cardiothoracic surgery at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles, Calif. Chloe Powell is a clinical instructor of family medicine in the Primary Care Physician Assistant Program at the University of Southern California's Keck School of Medicine in Alhambra, Calif. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Abstract

Heart failure is a leading cause of hospital admissions and death in the United States and worldwide. In 2016, the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America released a joint focused guideline update for the management of patients with Stage C heart failure with reduced ejection fraction. An additional update released in 2017 reinforces the 2016 update's strong recommendation for substituting angiotensin-converting enzyme inhibitors or angiotensin receptor blockers with an angiotensin receptor-neprilysin inhibitor to reduce morbidity and mortality in selected patients. The 2017 and 2016 updates also support adding a sinoatrial node modulator to further reduce heart rates in patients already maximized on beta-blocker therapy. These innovative therapies can significantly improve patients' quality of life and reduce the healthcare costs associated with managing heart failure.

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