April 01, 2022 2:00 PM

New guidelines overhaul best practices for heart failure prevention, diagnosis and treatment

Updated heart failure management guidelines add recommendations for the use of SGLT inhibitors and for managing patients with cancer therapy-related cardiotoxicity.

heart drawing with yellow and blue lab note
Michigan Medicine

Clinicians now have an up-to-date, data-driven destination to help them provide the best care possible to their patients with heart failure, thanks to the publication of new clinical practice guidelines from the American College of Cardiology, the American Heart Association and the Heart Failure Society of America.

The new guidelines provide a tremendous resource for physicians who are looking for the latest data to help them care for their patients, given that the last full guideline was published nearly 10 years ago, says Salim Hayek, M.D., an assistant professor of internal medicine and a cardiologist at the University of Michigan Health Frankel Cardiovascular Center, who served on the writing committee.

Physicians who care for patients with heart failure with and without reduced ejection fraction will find new recommendations regarding sodium-glucose cotransporter-2, or SGLT, inhibitors in the guideline.

“This class of drugs, initially meant for treating diabetes, have been shown to be amazing therapies for patients with heart failure,” Hayek said. “Most importantly, they work well in patients with heart failure and preserved ejection fraction, a group of patients for which effective treatments are lacking.”

Another key message is that heart failure specialty teams, like the Frankel CVC offers, are key to evaluating patients with advanced heart failure and providing life-saving therapies, added guideline writing committee member Monica Colvin, M.D., M.S., associate director of the heart transplant program and an advanced heart failure and transplant cardiologist at the Frankel CVC.

Reducing the prevalence of heart failure to begin with is also given great importance: The heart failure stages are revised to emphasize prevention for people at risk of heart failure or who have pre-heart failure.

In addition, economic analyses are included for some treatments, with value statements to help clinicians and patients who are determining whether to try something expensive. Only one therapy was defined as low-value: tafamidis for cardiac amyloidosis.

And for the first time, the guideline offers recommendations for cardio-oncology, a clinical focus for Hayek, providing guidance on the management and prevention of cancer-therapy related cardiotoxicity.

It’s important to note the patient-centric approach of the new guideline, Hayek and Colvin added.

Guideline cited: “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint 4 Committee on Clinical Practice Guidelines.”