The following are summary points to remember about the 2017 American College of Cardiology/American Heart Association/Heart Failure Society of America (ACC/AHA/HFSA)

1. Revision new guide heart failure
Cesar David Ordoñez Domínguez

2. Introduction
The scope of the focused update includes revision to the sections on
biomarkers; new therapies indicated for stage C HF with reduced ejection
fraction (HFrEF); updates on HF with preserved ejection fraction (HFpEF);
new data on important comorbidities, including sleep apnea, anemia, and
hypertension; and new insights into the prevention of HF.
Update on New Pharmacological Therapy for Heart Failure”, which
introduced guidance on new therapies, specifically for the use of an
angiotensin receptor–neprilysin inhibitor (ARNI) (valsartan/sacubitril) and a
sinoatrial node modulator (ivabradine).
New data on important comorbidities, including sleep apnea, anemia, and
hypertension; and new insights into the prevention of HF.

3. Initial and Serial Evaluation of the HF Patient
Biomarkers
• Assays for BNP (B-type natriuretic peptide) and NT-proBNP (N-
terminal pro-B-type natriuretic peptide), which are both natriuretic
peptide biomarkers, have been used increasingly to establish the
presence and severity of HF.
• Notably, BNP, but not NT-proBNP, is a substrate for neprilysin.
Therefore, ARNI increases BNP levels but not NT-proBNP levels..

6. Treatment of Stages A to D
Stage C
Pharmacological Treatment for Stage C HF With Reduced Ejection
Fraction

7. Treatment of Stages A to D
Stage C
Pharmacological Treatment for Stage C HF With Reduced Ejection
Fraction

8. Treatment of Stages A to D
Stage C
Pharmacological Treatment for Stage C HF With Reduced Ejection
Fraction

9. Treatment of Stages A to D
Stage C
Ivabradine: Recommendation

13. Pharmacological Treatment for Stage C HFpEF:
Recommendations
New

14. Important Comorbidities in HF
Anemia: Recommendations

15. Important Comorbidities in HF
Hypertension
Treating Hypertension to Reduce the Incidence of HF:
Recommendation

16. Important Comorbidities in HF
Hypertension
Treating Hypertension in Stage C HFrEF: Recommendation

17. Important Comorbidities in HF
Hypertension
Treating Hypertension in Stage C HFpEF: Recommendation

18. Important Comorbidities in HF
Sleep Disordered Breathing: Recommendations