Class I for HFrEF. Exhibited benefits comparable to enalapril in the VALIANT trial
Class I for those with EF ≤ 40%. Has been shown to impede adverse remodeling in reduced EF after an MI
BONUS GUIDELINE (ISHLT 2022): Many transplant pts have this level measured in the morning. Inhibits CYP3A4, and so need to watch for drug interactions
One of two antiarrhythmics with netural effect on mortality in HFrEF trials
Production blocked by 1 Across and 3 Across
The MADIT-II trial showed that primary prevention ICD implantation in those with prior MI and advanced LV dysfunction reduced this, for short
Class I rec, but only for those not responding to moderate or high-dose loop diuretics
Eplerenone is one of these. Class III if serum potassium cannot be maintained <5.5 mEq/L
Class IIa recommended in the diagnosis of HF. Helpful in processes such as amyloid, where diffuse late gadolnium enhancement may be seen
Levels are increased by 27 Across. Potential beneficial effects include decreased fibrosis, vasodilation, and improved endothelial function
BONUS GUIDELINE (ISHLT 2022): An HLA antibody check, for short. Class IIa to mesure when antibody-mediated rejection is suspected.
Class I to measure in newly diagnosed HF (though some disagree with this commonly used abbreviation)
Class I for HFrEF and NYHA Class II-IV if K < 5.0 mEq/L and eGFR >30 mL/min
Class IIa recommended in ambulatory pts with HF to assess functional capacity
BONUS GUIDELINE! ______-phic cardiomyopathy remains a more common condition than many realize with a prevalence from 1:200 - 1:500. Inherited in autosomal dominant pattern
Drug studied in the VICTORIA trial. Class IIa for selected HFrEF patients already on GDMT
Class IIb for HFrEF unable to tolerate first-line agents, but only when given with hydralazine
Must have this for 35 Down to be a Class I recommendation
May optimize an LVAD with this type of study
Nondihydropyridines may reduce this, and so are Class III with EF <50%.
This class of medication led to a greater reduction in NT-proBNP in the PIONEER-HF trial than enalapril without significantly different rates in worse renal function or hyperkalemia. Class III if given within 36 hours of last dose of ACEi!
Might lead to Na and water retention and so requires caution in HF
Trial that showed pts with ischemic or nonischemic CM, EF ≤35%, and Class II or III symptoms benefit from ICD placement
Noninvasive test that is Class IIb in pts with HF and CAD who are candidates for coronary revascularization to help guide management
A good place to meet guideline recs, but might also need a membership