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Changes in how cardiomyopathy is understood have been considerable in recent years. Although diagnosis and treatment guidelines regularly align, controversy remains regarding when to apply restrictions on sports participation. Of the many disease forms discussed in this article, hypertrophic cardiomyopathy is the most likely to be seen in primary care practice.
About one-half of the 5 million Americans diagnosed with heart failure have preserved ejection fraction. Find out which signs and symptoms increase the likelihood of heart failure, and get the latest evidence on which medications should be used to treat these patients.
Aug 1, 2017 Issue
Antiplatelet vs. Anticoagulation Therapy for Patients with Heart Failure in Sinus Rhythm [Cochrane for Clinicians]
Heart failure increases the risk of thrombotic complications, but use of warfarin does not lower all-cause mortality more than aspirin in patients with heart failure with reduced ejection fraction in sinus rhythm.
Treatment of iron deficiency in patients with heart failure using intravenous iron improves function, fatigue, and quality of life, and decreases risk of hospitalizations compared with placebo.
Multiple medication classes have demonstrated mortality benefit in heart failure. Recent data have shown benefit in two new classes—angiotensin blocker/neprilysin inhibitors and sinus node modulator.
Nov 1, 2016 Issue
Amiodarone for the Prevention of Sudden Cardiac Death [Cochrane for Clinicians]
Although not a substitute for an implantable cardioverter-defibrillator (ICD), amiodarone is effective for the primary prevention of sudden cardiac death when compared with placebo (number needed to treat [NNT] = 47; 95% confidence interval [CI], 33 to 100), but it does not significantly lower all-cause mortality in those at high risk.
Sacubitril/valsartan provides a small mortality benefit and decreases heart failure–related hospitalizations over and above an ACE inhibitor. It may be used in place of an ACE inhibitor in patients receiving optimal doses of guideline-directed medical therapy that includes ACE inhibitors, beta blockers, and aldosterone antagonists.
A care transition intervention that incorporates remote monitoring of weight, blood pressure, and heart rate with scheduled telephone coaching did not reduce readmission rates at 30 days or 180 days for patients with heart failure. However, patients in the study were only modestly adherent to the intervention strategies.
Review the components of this multidisciplinary program that improves daily function and reduces mortality risk in persons with cardiovascular disease.
Patients who have heart failure with preserved ejection fraction had decreased levels of activity and more adverse events when they were receiving isosorbide mononitrate than when they were taking a placebo. Moreover, activity levels decreased with increases in the dose of the drug, suggesting a str...