Otimização do tratamento da insuficiência cardíaca com fração de ejeção reduzida com fármacos modificadores de prognóstico: um documento de consenso de 2021 por especialistas em insuficiência cardíaca

Translated title of the contribution: Optimization of heart failure with reduced ejection fraction prognosis-modifying drugs: A 2021 heart failure expert consensus paper

José Silva-Cardoso, Cândida Fonseca, Fátima Franco, João Morais, Jorge Ferreira, Dulce Brito

Research output: Contribution to journalArticlepeer-review

Abstract

Heart failure (HF) with reduced ejection fraction (HFrEF) is associated with high rates of hospitalization and death. It also has a negative impact on patients’ functional capacity and quality of life, as well as on healthcare costs. In recent years, new HFrEF prognosis-modifying drugs have emerged, leading to intense debate within the international scientific community toward a paradigm shift for the management of HFrEF. In this article, we report the contribution of a Portuguese HF expert panel to the ongoing debate. Based on the most recently published clinical evidence, and the panel members’ clinical judgment, three key principles are highlighted: (i) sacubitril/valsartan should be preferred as first-line therapy for HFrEF, instead of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker; (ii) the four foundation HFrEF drugs are the angiotensin receptor/neprilysin inhibitor, beta-adrenergic blocking agents, mineralocorticoid receptor antagonists, and sodium-glucose co-transporter 2 inhibitors, regardless of the presence of type-2 diabetes mellitus; (iii) these four HFrEF drug classes should be introduced over a short-term period of four to six weeks, guided by a safety protocol, followed by a dose up-titration period of 8 weeks.

Translated title of the contributionOptimization of heart failure with reduced ejection fraction prognosis-modifying drugs: A 2021 heart failure expert consensus paper
Original languagePortuguese
JournalRevista Portuguesa de Cardiologia
DOIs
Publication statusE-pub ahead of print - 2021

Keywords

  • Beta-blockers
  • Heart failure
  • Heart failure prognosis-modifying drugs
  • Heart failure with reduced ejection fraction
  • Mineralocorticoid receptor antagonists
  • Sacubitril/valsartan
  • SGLT2-inhibitors
  • Treatment optimization

Fingerprint

Dive into the research topics of 'Optimization of heart failure with reduced ejection fraction prognosis-modifying drugs: A 2021 heart failure expert consensus paper'. Together they form a unique fingerprint.

Cite this