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<em>Decision-IQ:</em> Treating New-Onset Heart Failure With Reduced Ejection Fraction

Decision-IQ: Treating New-Onset Heart Failure With Reduced Ejection Fraction

Decision-IQ
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Developed in collaboration
Med-IQ      Duke Medicine

Online Course | Specialties: Cardiology, Family Medicine
Released: 4/20/2022
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Expires: 4/19/2023
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Max Credits: 0.25
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Faculty
Adam DeVore, MD, MHS
Advanced Heart Failure Specialist
Transplant Cardiologist
Duke University School of Medicine
Durham, NC
 
Activity Planners
Sara Samuel, MSc, MPhil, MS
Clinical Content Manager
Med-IQ
Baltimore, MD

Kerry Kennedy, ELS
Editorial Manager
Med-IQ
Baltimore, MD

Laura Rafferty, ELS
Senior Editorial Manager
Med-IQ
Baltimore, MD

Amy Sison
Director of CME
Med-IQ
Baltimore, MD
 
Learning Objective
Upon completion, participants should be able to:

  • Describe the importance of initiating evidence-based therapies for heart failure

Target Audience
This activity is intended for cardiologists, primary care physicians, nurse practitioners, and physician assistants.
 
Statement of Need
Management options for heart failure have changed during the last 20 years. Clinicians should be aware of recent clinical data on diagnostic approaches and nonsurgical treatment methods for heart failure. Additionally, studies show that patients who have heart failure with reduced ejection fraction must be optimized on medical therapy before being considered for transcatheter mitral valve repair. Medical management in these cases typically includes consideration of the following classes of medications: evidence-based beta blockers, angiotensin receptor–neprilysin inhibitors, aldosterone receptor antagonists, and SGLT2 inhibitors. According to the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure, these 4 classes of medication are the foundational pillars of therapy for heart failure with reduced ejection fraction. Clinicians must remain up-to-date about the protocols for optimizing medical management in patients with heart failure with reduced ejection fraction.

Collaboration Statement
This activity was developed by Med-IQ in collaboration with Duke Health.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
 
Med-IQ designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
Medium/Method of Participation
This CME activity consists of a 0.25-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: April 20, 2022
Expiration Date: April 19, 2023
Estimated Time to Complete This Activity: 15 minutes

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all financial relationships with any ineligible company over the past 24 months. The ACCME deems financial relationships as relevant if the educational content an individual can control is related to the business lines or products of the ineligible company. Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and mitigate COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are not mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been mitigated through an established COI mitigation process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Adam DeVore, MD, MHS, has indicated no real or apparent conflicts.

The peer reviewers and activity planners have no financial relationships to disclose. 
 
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.
 
Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.
 
Contact Information        
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email info@med-iq.com.

System Requirements
For system requirements and technical assistance, please refer to our Support Manual.

Disclaimer
The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Complimentary CME
This activity is available free of charge to participants.

Copyright
© 2022 Duke University Health System

Abstract

Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • As part of evaluating a patient for new-onset heart failure, a complete workup is vital to a proper diagnosis, including identifying underlying causes of heart failure
  • A complete evaluation should include a physical examination, medication review, vital sign assessment (blood pressure, heart rate, oxygen saturation), chest radiography, electrocardiography, echocardiography, and thyroid and diabetes tests as indicated
  • For patients hospitalized with acute heart failure with reduced ejection fraction, studies indicate that initiating sacubitril/valsartan therapy after hemodynamic stabilization can lead to a greater reduction in the NT-proBNP concentration than enalapril therapy alone
  • Patients with heart failure with reduced ejection fraction who are being considered for transcatheter mitral valve repair should first be optimized on medical therapy
  • Studies also show that patients with heart failure with reduced ejection fraction who receive dapagliflozin 10 mg once daily have a lower risk of worsening heart failure or death than those who receive placebo
  • Optimal medical management of patients with new-onset heart failure with reduced ejection fraction includes consideration of each of the following classes of medications: evidence-based beta blockers, angiotensin receptor–neprilysin inhibitors, aldosterone receptor antagonists, and SGLT2 inhibitors

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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