Head-to-head comparison between recommendations by the ESC and ACC/AHA/HFSA heart failure guidelines
Por:
Bayes-Genis, A, Aimo, A, Metra, M, Anker, S, Seferovic, P, Rapezzi, C, Castiglione, V, Nunez, J, Emdin, M, Rosano, G and Coats, AJS
Publicada:
1 jun 2022
Ahead of Print:
1 may 2022
Resumen:
Recommendations represent the core messages of guidelines, and are particularly important when the body of scientific evidence is rapidly growing, as in the case of heart failure (HF). The main messages from two latest major HF guidelines, endorsed by the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association/Heart Failure Society of America (ACC/AHA/HFSA), are partially overlapping, starting from the four pillars of treatment for HF with reduced ejection fraction. Some notable differences exist, in part related to the timing of recent publications (most notably, the Universal Definition of HF paper and the EMPEROR-Preserved trial), and in part reflecting differing views of the natural history of HF (with a clear differentiation between stages A and B HF in the ACC/AHA/HFSA guidelines). Different approaches are proposed to specific issues such as risk stratification and implantable cardioverter defibrillator use for primary prevention in HFrEF patients with non-ischaemic aetiology. The ACC/AHA/HFSA guidelines put a greater emphasis on some issues that are particularly relevant to the US setting, such as the cost-effectiveness of therapies and the impact of health disparities on HF care. A comparison between guideline recommendations may give readers a deeper understanding of the ESC and ACC/AHA/HFSA guidelines, and help them apply sensible approaches to their own practice, wherever that may be in the world. A comparison may possibly also help further harmonization of recommendations between future guidelines, by identifying why some areas have led to conflicting recommendation, even when ostensibly reviewing the same published evidence.
Filiaciones:
:
Hosp Badalona Germans Trias & Pujol, Inst Cor, Badalona, Spain
Carlos III Inst Hlth, CIBERCV, Madrid, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Aimo, A:
Inst Life Sci, Scuola Super SantAnna, Pisa, Italy
Fdn Toscana Gabriele Monasterio, Div Cardiol, Pisa, Italy
Metra, M:
ASST Spedali Civili, Cardiol Div, Brescia, Italy
Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Brescia, Italy
Anker, S:
Charite Univ Klinikum Berlin, Dept Cardiol CVK, Berlin, Germany
Charite Univ Klinikum Berlin, Berlin Inst Hlth Ctr Regenerat Therapies BCRT, Berlin, Germany
Charite Univ Klinikum Berlin, German Ctr Cardiovasc Res DZHK, Partner Site Berlin, Berlin, Germany
Seferovic, P:
Univ Belgrade, Fac Med, Belgrade, Serbia
Serbian Acad Arts & Sci, Belgrade, Serbia
Rapezzi, C:
Univ Ferrara, Ctr Cardiol, Ferrara, Italy
Maria Cecilia Hosp, GVM Care & Res, Ravenna, Italy
Castiglione, V:
Inst Life Sci, Scuola Super SantAnna, Pisa, Italy
Fdn Toscana Gabriele Monasterio, Div Cardiol, Pisa, Italy
Nunez, J:
Univ Valencia, Hosp Clin Univ Valencia, Dept Cardiol, INCLIVA, Valencia, Spain
Emdin, M:
Inst Life Sci, Scuola Super SantAnna, Pisa, Italy
Fdn Toscana Gabriele Monasterio, Div Cardiol, Pisa, Italy
Rosano, G:
IRCCS San Raffaele Roma, Rome, Italy
Coats, AJS:
Inst Life Sci, Scuola Super SantAnna, Pisa, Italy
Univ Warwick, Coventry, W Midlands, England
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