BIG MOOD: Managing Depression in Patients with Heart Failure

Depression is a common comorbidity in patients with heart failure. Despite being associated with worse outcomes, depression is often unaddressed in this population, possibly due to unfamiliarity of cardiologists with proper diagnosis and management of this disease. Recent data continues to be conflicting in how to address this comorbidity. In this post, Dr. Gale discusses the evidence for managing depression in patients with cardiovascular disease.

Formulary Decisions Matter: 4 reasons to add SGLT2i to your inpatient formulary

Several advances in the pharmacologic treatment of heart failure with reduced ejection fraction (HFrEF) have been made in the past several years. Despite known benefits, use of guideline-directed medical therapy in these patients remains wildly suboptimal. There are several reasons for this, including increasing complexity of HF regimens as well therapeutic inertia. While we may not have control over all components of therapeutic inertia, we feel strongly as a pharmacist that we cannot let our inpatient formulary decisions be one of them. As such, here we discuss 4 reasons why you should add these agents to formulary.

Managing Septic Shock in Patients with a Broken Heart: Focus on Hemodynamic Management with Fluids and Vasoactive Agents

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Currently, national guidelines do not address sepsis management in patients with underlying heart failure with reduced ejection fraction (HFrEF). Several factors make the management of sepsis in patients with HFrEF uniquely challenging, including a heightened risk of volume overload and the need for alternative vasoactive regimens to maintain cardiac output. The purpose of this blog is to provide practical considerations in the hemodynamic management of septic patients with HFrEF using fluids and vasoactive agents.

Help or Hype: Vericiguat for Heart Failure with Reduced Ejection Fraction

The recently published VICTORIA study assessed the efficacy and safety of vericiguat, a soluble guanylate cyclase stimulator in patients with heart failure with reduced ejection fraction, and met its primary composite outcome of death from cardiovascular causes or first hospitalization for heart failure. This blog describes four reasons why despite a technically positive study, I’m not sure I see a significant role for vericiguat in this population.

TRED Lightly: Should Guideline-Directed Medical Therapy be Continued Indefinitely in Everyone?

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.