The TRED-HF trial considerably narrowed the population deemed as being low risk for heart failure relapse following the withdrawal of guideline-directed medical therapy (GDMT). However, several key subgroups were underrepresented and some patients may still wish to attempt GDMT withdrawal, especially in the setting of adverse effects or excess costs. In this post, we explore three questions that can be used to guide a shared decision-making process regarding GDMT withdrawal.
Angiotensin II Receptor Blocker Recalls
Unsure how to handle the angiotensin II receptor blocker recalls? Check out our table of comparable doses to select an appropriate alternative!
3 Reasons You Should Stop Using Dopamine
Of the available agents for treating shock, dopamine remains unusually popular. Although the drug’s varying effects at different doses are thought to afford it several advantages compared to other vasoactive agents, in this post I’ll share three reasons why you should consider replacing dopamine in your practice.
Lessons Learned in the Management of Heart Failure GDMT (Part 1): Beta-Blockers in Acute Decompensated Heart Failure
In patients with heart failure, guideline-directed medical therapy is often mismanaged during acute decompensation, particularly with regard to beta-blocker therapy. In this entry, we discuss how to manage beta-blockers in patients with acute decompensated heart failure.
Getting to the Heart of the Patient Interview: A Focus on Heart Failure (Part II)
A thorough and accurate patient assessment is critical to managing patients with heart failure. In this second post of our two-part series, we’ll focus on volume status and adherence to medications and dietary recommendations. Check out our first post for general principles and an assessment of functional status. A template collection tool is also provided.
Getting to the Heart of the Patient Interview: A Focus on Heart Failure (Part I)
A thorough and accurate patient assessment is critical to managing patients with heart failure. In this two-part series, we’ll provide an overview of the key components of assessing patients with heart failure, starting first with general principles and an evaluation of functional status. Our second piece will focus on volume status and adherence to medications and dietary recommendations. A template collection tool is also provided.
Titration of Renin-Angiotensin System Inhibitors in Patients with Heart Failure with Reduced Ejection Fraction and an “At-Goal” Blood Pressure
Initiation and titration of guideline-directed medical therapy is paramount for patients with heart failure with reduced ejection fraction (HFrEF), as it reduces the risk of death and other complications. Despite this, many patients do not receive the appropriate therapies or doses due to concerns and/or misconceptions about the use of these therapies. One reason often cited for not using or titrating inhibitors of the renin-angiotensin system is that blood pressure is already “at goal” or is “too low”. In this blog, the data surrounding titration of angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and the angiotensin II receptor blocker/neprilysin inhibitor in patients with HFrEF will be addressed.
10 Grams or Bust: What is the Appropriate Loading Dose of Amiodarone?
Have you ever wondered where the magic “10 gram” number comes from when determining a loading dose of amiodarone? In this blog we will review the data surrounding amiodarone loading in patients with atrial fibrillation and hemodynamically stable ventricular arrhythmias.
Hemoglobin A1c Goals in Patients with Type 2 Diabetes Mellitus and Established Cardiovascular Disease
Treatment of diabetes is associated with a reduction in both macro- and microvascular complications. Macrovascular complications include myocardial infarction and stroke. One of the goals of therapy for patients with type 2 diabetes mellitus is a reduction in hemoglobin A1c (HbA1c). The goal or target HgbA1c is individualized for patients based on the presence of comorbidities, among other factors. Cardiovascular disease (CVD), when present, may influence an individual’s HbA1c goal. This blog will review the data surrounding the HbA1c goal in those with type II diabetes and established CVD.
Desensitizing Patients with an Aspirin Allergy
Share this post:Author: Brent N. Reed, PharmD, BCPS-AQ Cardiology, FAHA About five years ago, I wrote a post on the approach we used at my prior institution to desensitize patients to aspirin. In the time since then, I’ve received several