Canadian Cardiovascular Society Consensus Conference recommendations on heart failure update 2007: Prevention, management during intercurrent illness or acute decompensation, and use of biomarkers.
Heart failure is common, yet it is difficult to treat. It presents in many different guises and circumstances in which therapy needs to be individualized. The Canadian Cardiovascular Society published a comprehensive set of recommendations in January 2006 on the diagnosis and management of heart failure, and the present update builds on those core recommendations. Based on feedback obtained through a national program of heart failure workshops during 2006, several topics were identified as priorities because of the challenges they pose to health care professionals. New evidence-based recommendations were developed using the structured approach for the review and assessment of evidence adopted and previously described by the Society. Specific recommendations and practical tips were written for the prevention of heart failure, the management of heart failure during intercurrent illness, the treatment of acute heart failure, and the current and future roles of biomarkers in heart failure care. Specific clinical questions that are addressed include: which patients should be identified as being at high risk of developing heart failure and which interventions should be used? What complications can occur in heart failure patients during an intercurrent illness, how should these patients be monitored and which medications may require a dose adjustment or discontinuation? What are the best therapeutic, both drug and nondrug, strategies for patients with acute heart failure? How can new biomarkers help in the treatment of heart failure, and when and how should BNP be measured in heart failure patients? The goals of the present update are to translate best evidence into practice, to apply clinical wisdom where evidence for specific strategies is weaker, and to aid physicians and other health care providers to optimally treat heart failure patients to result in a measurable impact on patient health and clinical outcomes in Canada.
Arnold
J Malcom O
JM
University of Western Ontario, London, Canada. malcolm.arnold@lhsc.on.ca
Howlett
Jonathan G
JG
Dorian
Paul
P
Ducharme
Anique
A
Giannetti
Nadia
N
Haddad
Haissam
H
Heckman
George A
GA
Ignaszewski
Andrew
A
Isaac
Debra
D
Jong
Philip
P
Liu
Peter
P
Mann
Elizabeth
E
McKelvie
Robert S
RS
Moe
Gordon W
GW
Parker
John D
JD
Svendsen
Anna M
AM
Tsuyuki
Ross T
RT
O'Halloran
Kelly
K
Ross
Heather J
HJ
Rao
Vivek
V
Sequeira
Errol J
EJ
White
Michel
M
D000208:Acute Disease; D015415:Biomarkers; D002170:Canada; D002303:Cardiac Output, Low / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D002908:Chronic Disease; D015897:Comorbidity; D019317:Evidence-Based Medicine; D006292:Health Priorities; D006333:Heart Failure / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D020097:Natriuretic Peptide, Brain; D017410:Practice Guidelines as Topic; D012307:Risk Factors
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain