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The American College of Cardiology (ACC) has released updated guidance for managing patients hospitalized with heart failure (HF), aiming to provide a decision-making pathway that tailors therapy to the clinical trajectory of the disease. This updated Expert Consensus Decision Pathway (ECDP) integrates the latest evidence to assist clinicians at the point of care, complementing the 2022 ACC/AHA Heart Failure Guideline.
The "2024 ACC Expert Consensus Decision Pathway on Clinical Assessment, Management, and Trajectory of Patients Hospitalized With Heart Failure Focused Update" is published in the Journal of the American College of Cardiology (JACC).
The updated ECDP emphasizes the importance of establishing all four pillars of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) during hospitalization, alongside ensuring appropriate follow-up to monitor medication tolerance and continuation. It addresses management strategies for patients with varying short-term clinical trajectories, updates on alternative agents and dosing strategies for diuresis, and incorporates telehealth for improved communication and follow-up.
Additionally, the ECDP highlights the need for long-term disease trajectory discussions, including identifying patients who may require palliative care. This comprehensive approach aims to improve both immediate and long-term outcomes for patients with heart failure.
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