期刊
AKTUELLE KARDIOLOGIE
卷 11, 期 4, 页码 308-313出版社
GEORG THIEME VERLAG KG
DOI: 10.1055/a-1861-1067
关键词
heart failure; HFrEF; pharmacotherapy
The current guidelines recommend early and simultaneous use of multiple drug classes for the pharmacotherapy of heart failure, including beta-blockers, SGLT2 inhibitors, mineralocorticoid receptor antagonists, ACE inhibitors or angiotensin receptor neprilysin inhibitors. The choice of drugs and dosage may vary based on individual patient characteristics and comorbidities.
The current guidelines for the pharmacotherapy of heart failure with reduced ejection fraction recommend the early and, if possible, simultaneous start of a beta-blocker (BB), SGLT2-inhibitor (SGLT2i), mineralocorticoid receptor antagonist (MRA) and ACE inhibitor (ACEi) or, alternatively, angiotensin receptor neprilysin inhibitor (ARNI). The choice of these drug classes used at the beginning and their expansion and dose increase over the course of time is deliberately left to the treating physician, taking into account the individual patient characteristics and comorbidities. This means that the previous recommendations for a sequential initiation of the various drug classes are abandoned, as these are primarily based on the history of the underlying clinical endpoint trials and do not do justice to the early and synergistic prognosis-improving effects of the drug classes. However, the recommendation to increase the dose of BB, SGLT2i, MRA and ACEi/ARNI to the target doses used in clinical trials remains in place. The inclusion of other drug groups should depend on comorbidities, clinical parameters, progression of heart failure and evidence from clinical studies.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据