Cleveland Clinic Journal of MedicineHeart Failure with Reduced Ejection Fraction: What’s New in the 2022 Guideline?

Key practice-changing points from the latest guidelines:

• 1st line therapy is sacubitril plus valsartan, as this combination increases survival and reduces hospitalizations versus ACE inhibitors and ARBs.
• ACE inhibitors should be used only in patients who cannot tolerate sacubitril-valsartan, and ARBs used only in those who cannot tolerate either the 1st- or 2nd-line recommended therapies.
• Patients whose ejection fraction increases to more than 40% under therapy should continue to receive therapy.