2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways

Task Force on Expert Consensus Decision Pathways James L. Januzzi, Jr, MD, FACC, Chair Luis C. Afonso, MBBS, FACC Brendan Everett, MD, FACC Adrian F. Hernandez, MD, MHS, FACC William Hucker, MD, PhD Hani Jneid, MD, FACC Joseph Edward Marine, MD, FACC Pamela Bowe Morris, MD, FACC Robert N. Piana, MD,...

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Published in:	Journal of the American College of Cardiology 2018-01, Vol.71 (2), p.201-230
Main Authors:	Yancy, Clyde W, Januzzi, Jr, James L, Allen, Larry A, Butler, Javed, Davis, Leslie L, Fonarow, Gregg C, Ibrahim, Nasrien E, Jessup, Mariell, Lindenfeld, JoAnn, Maddox, Thomas M, Masoudi, Frederick A, Motiwala, Shweta R, Patterson, J Herbert, Walsh, Mary Norine, Wasserman, Alan
Format:	Article
Language:	eng
Subjects:	Cardiology Cardiology - methods Clinical Decision-Making - methods Clinical outcomes Consensus Ejection fraction Epidemiology Heart diseases Heart failure Heart Failure - epidemiology Heart Failure - physiopathology Heart Failure - therapy Humans Older people Optimization Patient Care Management - methods Patient Care Management - standards Patients Practice Guidelines as Topic Practice Patterns, Physicians' - standards Stroke Volume United States - epidemiology
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Summary:	Task Force on Expert Consensus Decision Pathways James L. Januzzi, Jr, MD, FACC, Chair Luis C. Afonso, MBBS, FACC Brendan Everett, MD, FACC Adrian F. Hernandez, MD, MHS, FACC William Hucker, MD, PhD Hani Jneid, MD, FACC Joseph Edward Marine, MD, FACC Pamela Bowe Morris, MD, FACC Robert N. Piana, MD, FACC Karol E. Watson, MD, FACC Dharam Kumbhani, MD, SM, FACC Barbara S. Wiggins, PharmD, FACC Table of Contents PREFACE202 ABSTRACT202 Introduction203 Methods203 Assumptions and Definitions204 Pathway Summary Graphic204 Description and Rationale: Answers to 10 Pivotal Issues in HF205 How to Initiate, Add, or Switch to New Evidence-Based Guideline-Directed Therapy for HFrEF205 How to Achieve Optimal Therapy Given Multiple Drugs for HF Including Augmented Clinical Assessment That May Trigger Additional Changes in GDMT (e.g., Imaging Data, Biomarkers, and Filling Pressures)211 When to Refer to an HF Specialist215 How to Address Challenges of Care Coordination215 How to Improve Adherence216 What Is Needed in Specific Patient Cohorts: African Americans, the Frail, and Older Adults218 How to Manage Your Patients’ Cost of Care for HF219 How to Manage the Increasing Complexity of HF220 How to Manage Common Comorbidities222 How to Integrate Palliative Care and Transition to Hospice Care222 Discussion and Implication of Pathway223 ACC President and Staff224 References224 Appendix 1 Author Relationships With Industry and Other Entities227 Appendix 2 Peer Reviewer Information229 Appendix 3 Abbreviations230 Preface The American College of Cardiology (ACC) develops a number of policy documents to provide members with guidance on clinical topics.The Task Force also established criteria for identifying high-value clinical topics to be addressed, as well as an innovative approach to collecting stakeholder input through a roundtable or think tank meeting.James L. Januzzi, Jr, MD, FACC Chair, ACC Task Force on Expert Consensus Decision Pathways Abstract The 2017 ACC/AHA/Heart Failure Society of America (HFSA) heart failure (HF) guidelines (1) reflect a focused update of the ACC/AHA 2013 HF guidelines (2) and include guidance based on new evidence supporting novel drug therapies, a new treatment algorithm replete with more options for care than before, an updated approach to prevention, and important updates regarding various forms of HF and important comorbidities.Participants attending the HF roundtable meeting included cardiologists, internists, emergency physicians, hospitalis
ISSN:	0735-1097 1558-3597