Heart failure with reduced ejection fraction

Also known as: CHF · HFrEF · systolic heart failure

United StatesACC/AHA

Current

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure

ACC/AHA/HFSA · 2022

The current US heart-failure guideline. It replaced the 2013 ACCF/AHA guideline and its 2017 focused update and established guideline-directed medical therapy across HF stages.

Establishes four foundational drug classes ('pillars') of guideline-directed medical therapy for HFrEF. source
Introduces universal definitions and revised HF stages and ejection-fraction categories. source

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EuropeESC

Current

2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

ESC (HFA) · 2023 · 2023 Focused Update of 2021

The current European heart-failure guidance — a 2023 focused update of the 2021 ESC guideline, revised after major new trials.

Gives a Class I recommendation for SGLT2 inhibitors in HFmrEF and HFpEF to reduce HF hospitalisation and cardiovascular death. source
Recommends intravenous iron for iron-deficient patients with HFrEF or HFmrEF to improve symptoms and quality of life. source

Verify against original ↗

US vs EU key differences

The two guidelines are broadly aligned on guideline-directed medical therapy, including the four foundational drug classes for HFrEF. source
The European guidance is more recent by way of its 2023 focused update, which strengthened SGLT2-inhibitor recommendations for HFmrEF/HFpEF. source

What changed recently

No recorded changes yet for this disease.

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