Fast Five Quiz: Heart Failure Management

Yasmine S. Ali, MD

Disclosures

September 11, 2019

ARNI therapy is an appropriate treatment option for HFrEF for patients in whom there is no history of angioedema. ARNIs, a relatively new therapeutic class of drugs, treat heart failure by inhibiting the renin-angiotensin-aldosterone and neutral endopeptidase systems. Studies have shown that ARNI therapy significantly reduces death or hospitalization of patients with moderate to severe heart failure and LV systolic dysfunction.

To address treatment with this new class of heart failure drugs, both the 2016 ACC/AHA/HFSA update on new pharmacologic therapy for heart failure (developed in collaboration with the International Society for Heart and Lung Transplantation [ISHLT]) and the 2016 ESC guidelines offer pharmacologic guidelines and treatment recommendations for heart failure based on the type and stage of heart failure and the severity of symptoms.

Whereas the 2016 ACC/AHA/HFSA focused update recommends the use of ARNI therapy in conjunction with a beta-blocker for symptomatic patients who can tolerate ACEI or ARB therapy, the 2016 ESC guideline recommends first treating patients with a mineralcorticoid receptor antagonist before initiating treatment with an ARNI.

For more on the 2016 ACC/AHA/HFSA and 2016 ESC pharmacologic treatment recommendations for heart failure, read here.

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