Heart Failure

Jan 1, 2017 Issue
Heart Failure Due to Reduced Ejection Fraction: Medical Management [Article]

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.

Oct 15, 2016 Issue
Sacubitril/Valsartan (Entresto) for Heart Failure [STEPS]

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.

Jul 15, 2016 Issue
No Reduction in Readmissions with Telemonitoring, Coaching for Patients with Heart Failure [POEMs]

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.

Jul 1, 2016 Issue
Cardiac Rehabilitation: Improving Function and Reducing Risk [Article]

Review the components of this multidisciplinary program that improves daily function and reduces mortality risk in persons with cardiovascular disease.

May 1, 2016 Issue
Long-Acting Nitrates No Good for Heart Failure with Preserved Ejection Fraction [POEMs]

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...

Apr 15, 2016 Issue
Ivabradine (Corlanor) for Heart Failure [STEPS]

In patients with stable systolic heart failure already on maximal medication therapy, adding ivabradine may reduce the number of hospitalizations related to heart failure (NNT for two years = 20), but it does not reduce cardiovascular mortality. In addition, many patients will not tolerate the drug ...

Mar 1, 2016 Issue
Transitional Care Interventions to Prevent Readmissions for Patients with Heart Failure [Implementing AHRQ Effective Health Care Reviews]

Home visiting programs and multidisciplinary clinic interventions for adult patients with heart failure reduced all-cause readmissions and mortality over three to six months. Structured telephone support reduced heart failure–specific readmissions and mortality over three to six months. However, str...

Apr 1, 2015 Issue
Valsartan/Sacubitril Reduces Mortality More Than Enalapril 10 mg Twice Daily in Patients With Heart Failure [POEMs]

The combination of an angiotensin receptor blocker (valsartan) and neprilysin inhibitor (sacubitril) reduces cardiovascular mortality more than an angiotensin-converting enzyme (ACE) inhibitor (enalapril [Vasotec]) alone, with an acceptable safety and tolerability profile. The choice of dosage is co...

Feb 15, 2015 Issue
Diagnosing and Managing Acute Heart Failure Guidelines: NICE [POEMs]

There is not much new in these guidelines except some caveats on what not to do. Diagnose new acute heart failure with a natriuretic peptide measurement and, if the level is high, follow with transthoracic echocardiography. Do not routinely treat with opiates, nitrates, inotropes, vasopressors, or c...

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