ACC Expert Consensus Decision Pathway for Managing In-Patient HF Published

August 8, 2024—The American College of Cardiology (ACC) announced it has issued updated guidance on managing patients hospitalized for heart failure (HF) that provides a decision-making pathway that tailors therapy to clinical trajectory to better manage disease.

According to ACC, the updated Expert Consensus Decision Pathway (ECDP) incorporates the latest evidence to provide guidance for clinicians to use at the point of care in conjunction with the 2022 ACC and American Heart Association HF guideline.

Steven M. Hollenberg, MD, et al published “2024 ACC Expert Consensus Decision Pathway on Clinical Assessment, Management, and Trajectory of Patients Hospitalized With Heart Failure Focused Update: A Report of the American College of Cardiology Solution Set Oversight Committee” online in JACC.

Dr. Hollenberg, who serves as the ECDP writing committee chair, is director of Cardiac Intensive Care at the Emory Heart & Vascular Center in Atlanta, Georgia.

“Clinicians should be assessing and optimizing therapy during a hospital stay to not only provide a good clinical response in the hospital but also to address a patient’s long-term trajectory after discharge,” commented Dr. Hollenberg in the ACC press release. “The updated ECDP places increased emphasis on establishing all four pillars of guideline-directed medical therapy for HF with reduced ejection fraction in the hospital, when possible, along with ensuring appropriate follow-up to monitor tolerance and continue medication.”

The ACC press release stated that the ECDP specifically addresses management strategies in patients with different short-term clinical trajectories in the hospital, provides updates on alternative agents and dosing strategies for diuresis; updates communications and follow-up recommendations to incorporate telehealth; and provides additional emphasis on long-term disease trajectory, including care discussions and identification of patients who may need palliative care.