2023 Focused Update of ESC HF guidelines entails new recommendations in three sections

2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Presented at the ESC congress 2023 by: Theresa McDonagh, MD - London, UK and Marco Metra, MD - Brescia, Italy.

Three sections in the 2021 ESC guidelines for HF were updated based on new evidence of several RCTs that should change the management of patients with HF. New recommendations in the 2023 Focused Update included those for the treatment of HFmrEF, HFpEF, acute HF, comorbidities and prevention.

New recommendations on chronic HF

• SGLT2 inhibitors (dapagliflozin or empagliflozin) are recommended for the management of patients with HFmrEF to reduce the risk of HF hospitalization or CV death (Class I, A)
• SGLT2 inhibitors (dapagliflozin or empagliflozin) are recommended for the management of patients with HFpEF to reduce the risk of HF hospitalization or CV death (Class I, A)

New recommendations on acute HF

• An intensive strategy of initiation and rapid up-titration of evidence-based treatment before discharge and during follow-up visits following hospital admission for acute HF is recommended to reduce HF hospitalization or death (Class I, B).

New recommendations on comorbidities and prevention

• SGLT2 inhibitors (dapagliflozin or empagliflozin) are recommended for patients with T2D and CKD to reduce the risk of HF hospitalization or CV death (Class I, A).
• Finerenone is recommended in patients with T2D and CKD to reduce the risk of HF hospitalization (Class I, A).
• In symptomatic patients with HFrEF and HFmrEF and iron deficiency, IV iron supplementation is recommended to alleviate HF symptoms and improve QoL (Class I, A).
• Ferric carboxymaltose or ferric derisomaltose should be considered in symptomatic patients with HFrEF and HFmrEF and iron deficiency to reduce the risk of HF hospitalization (class IIa, A).

- Our reporting is based on the information provided at the ESC Congress -

Find here the full publication of the 2023 Focused Update