Outpatient Management of Heart Failure
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This document discusses outpatient management of heart failure. It defines heart failure and describes its prevalence, incidence, classification, prognosis, clinical diagnosis and evaluation. It outlines a staged approach to heart failure therapy based on the presence or absence of symptoms and structural heart disease. Key recommendations include use of ACE inhibitors, ARBs, beta-blockers, aldosterone antagonists, diuretics, digoxin, and devices like ICDs and CRT depending on the stage of heart failure.
![Definition of Heart Failure ,[object Object],Chronic Heart Failure](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Outpatient Management of Heart Failure
- 1. Outpatient Management of Heart Failure Guilherme Oliveira, MD Staff, Section of Heart Failure and Transplant Medicine Cleveland Clinic, Cleveland, OH
- 35. THANK YOU
Notas del editor
- In the HOPE study (9297 patients, relative risk of the composite outcome of MI, stroke, or death from CV causes in the ramipril group as compared with the placebo group was 0.78 at five years. The risk of HF was decreased by 23%. Results independent of BP. In EUROPA the relative risk reduction of CV death, MI, or cardiac arrest was 20%.
- In the HOPE study (9297 patients, relative risk of the composite outcome of MI, stroke, or death from CV causes in the ramipril group as compared with the placebo group was 0.78 at five years. The risk of HF was decreased by 23%. Results independent of BP. In EUROPA the relative risk reduction of CV death, MI, or cardiac arrest was 20%.
- In the HOPE study (9297 patients, relative risk of the composite outcome of MI, stroke, or death from CV causes in the ramipril group as compared with the placebo group was 0.78 at five years. The risk of HF was decreased by 23%. Results independent of BP. In EUROPA the relative risk reduction of CV death, MI, or cardiac arrest was 20%.
- 2231 Post- MI asymptomatic LV dysfunction (EF<40%). CV mortality 21% RR, HF development 37% RR, recurrent MI 25%RR
- 1959 post-MI patients with EF< or= 40%, on ACE-I, ASA, revascularization. Carvedilol vs. Placebo.
- In the HOPE study (9297 patients, relative risk of the composite outcome of MI, stroke, or death from CV causes in the ramipril group as compared with the placebo group was 0.78 at five years. The risk of HF was decreased by 23%. Results independent of BP. In EUROPA the relative risk reduction of CV death, MI, or cardiac arrest was 20%.
- In the HOPE study (9297 patients, relative risk of the composite outcome of MI, stroke, or death from CV causes in the ramipril group as compared with the placebo group was 0.78 at five years. The risk of HF was decreased by 23%. Results independent of BP. In EUROPA the relative risk reduction of CV death, MI, or cardiac arrest was 20%.
- 2569 patients with EF<35% and HF symptoms- enalapril vs. placebo
- Val-Heft- 366 patients not on ACE-I without a reason Charm-Alternative- 2028 symptomatic HF patients with EF<40% not on ACE because of previous intolerance
- 1050 AA patients with class 3 or 4 HF. Stopped early
- MUSTT (Multicenter Unsustained Tachycardia Trial)- 700 patients LVEF≤40% and NSVT- EP guided induced VT- antiarrhythmic therapy (ICD vs drugs) vs placebo - antiarrhytmic vs ICD: RR-24% Unlike MADIT, there was no EP study before randomization.
- Class 1A indication Class 2A indication with Atrial fibrillation Class 2B with EF≤35% class I or II, if other indication for pacing present.
- In the HOPE study (9297 patients, relative risk of the composite outcome of MI, stroke, or death from CV causes in the ramipril group as compared with the placebo group was 0.78 at five years. The risk of HF was decreased by 23%. Results independent of BP. In EUROPA the relative risk reduction of CV death, MI, or cardiac arrest was 20%.