Go with the Heart Failure Guidelines: ACC 2022, ESC 2021

Go with the Heart Failure Guidelines: ACC 2022, ESC 2021

1.     Heart failure (HF) is a serious problem in India with high mortality, a high rate of recurrent hospitalization and poor quality of life.

2.    Four foundational groups of medicines have improved the outcome greatly, but the uptake in India is still very poor.

3.   All efforts must be made to introduce these medicines as soon as the diagnosis of heart failure with reduced ejection fraction (HFrEF) is made and attain the highest tolerated recommended doses.

4.    Admission with acute HF should not be a cause for discontinuation of therapy if already on. Instead, it is recommended to introduce the medicines, if not on already, before hospital discharge.

5.     In the renin-angiotensin-aldosterone system (RAAS) blocker category, angiotensin receptor-neprilysin inhibitor (ARNI) has been recommended by all guidelines as the default choice, and ACEI/ARB is only used if ARNI cannot be given for some reason.

6.    De novo HF is no different from acute exacerbation of chronic HF and should be treated with similar aggression.

7.     For long-term improvement in the quality of HF care in India, a concerted effort must be made among all stakeholders with public and doctor education, development of infrastructural facilities, affordable and available medicines, and formation of paramedical HF support teams.

Dr. Saumitra Ray

Dr. Saumitra Ray is a Professor at Vivekananda Institute of Medical Sciences, Kolkata. He practices as a Senior Interventional Cardiologist at Woodlands Hospital and Sri Aurobindo Seva Kendra in Kolkata. He also has a private practice at Ballygunge Place, Kolkata. Dr. Saumitra Ray has excelled at academics right from the higher secondary level, having topped the West Bengal state HSC examination, The MBBS Joint Entrance Exam and thereafter all the MBBS examinations. He was awarded 15 Gold Medals for his efforts, and also won the University Gold Medal at the MD level. Dr. Ray then moved to the United Kingdom where he attained membership of the Royal College of Physicians. He worked as a Speciality and Research Registrar at a number of London University Hospitals, before returning to India. Dr. Ray has published many papers in journals and written chapters in books. He is a fine orator and debater. Dr. Ray plays an active role in the Cardiological Society of India, at the state level as well as at the national level.

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