What is the main drug of choice for heart failure?
Some of the main medicines for heart failure include: ACE inhibitors. angiotensin-2 receptor blockers (ARBs or AIIRAs) beta blockers.
Healthcare providers often prescribe ACE inhibitors and beta blockers as first-line treatments. These drugs are especially helpful for people who have a reduced ejection fraction. This means your left ventricle (the main pumping chamber of your heart) isn't pumping enough blood to your body.
Loop diuretics should be used as first-line agents, with thiazides added for refractory fluid overload. Diuretic treatment should be combined with a low-salt diet,8 a β-blocker, and an ACE inhibitor. The practitioner should begin with oral furosemide, 20 to 40 mg once daily.
and Indianapolis, August 18, 2021 – Jardiance® (empagliflozin) 10 mg has been approved by the U.S. Food and Drug Administration to reduce the risk of cardiovascular death plus hospitalization for heart failure in adults with heart failure with reduced ejection fraction (HFrEF), Boehringer Ingelheim and Eli Lilly and ...
ACE inhibitors or ARB drugs improve heart function and life expectancy. Digitalis glycosides strengthen the heart's contractions. Anticoagulants or antiplatelets such as aspirin help prevent blood clots. Beta-blockers improve heart function and chances of living longer.
Today, the U.S. Food and Drug Administration approved Farxiga (dapagliflozin) oral tablets for adults with heart failure with reduced ejection fraction to reduce the risk of cardiovascular death and hospitalization for heart failure.
In October 2019 the US FDA approved FARXIGA to reduce the risk of hospitalization for HF in adult patients with T2D and established CV disease or multiple CV risk factors. The approval was based on the DECLARE-TIMI 58 trial.
Known as the “four pillars” of heart failure therapy, these medications are beta blockers, angiotensin receptor-neprilysin inhibitors (ARNIs), mineralcorticoid receptor antagonists (MRAs) and sodium-glucose co-transporter 2 Inhibitors (SGLT2i).
Spironolactone (Aldactone)
Spironolactone at a target dose of 25 mg has been shown to improve survival in patients with heart failure and reduced ejection fraction.
Soon to hit the market is a new heart failure drug sotagliflozin (brand name Inpefa), which was approved by the FDA on May 26, 2023.
What is the gold treatment for heart failure?
Heart transplants are the gold standard treatment for patients with end-stage heart failure.
In June 2023, the FDA approved Lodoco to reduce the risk of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in adult patients. Lodoco is the first drug approved to target inflammation that is an underlying cause of atherosclerotic cardiovascular disease.
- Nonsteroidal anti-inflammatory drugs. Aspirin.
- Calcium channel blockers.
- Drugs that may cause hyperkalemia.
- Trimethoprim-sulfamethoxazole.
- Antidepressants.
- Oral hypoglycemic agents. Thiazolidinediones. Metformin.
- Phosphodiesterase inhibitors. PDE-3 inhibitors. PDE-5 inhibitors.
- Antiarrhythmic agents.
Entresto is a heart medicine used in adults with chronic (long-term) heart failure who have symptoms of the disease and reduced ejection fraction (a measure of how well the heart pumps blood).
Left untreated, it can be life-threatening. While no one can predict exactly how heart failure will affect someone's life or how it may shorten a life, in general, more than half of all people diagnosed with congestive heart failure will survive for five years.
Research estimates that more than half of all people with congestive heart failure will survive for 5 years after diagnosis. About 35% will survive for 10 years. However, in some cases, a person can extend their life expectancy through lifestyle changes, medications, and surgery.
Entresto has an average rating of 4.9 out of 10 from a total of 193 ratings on Drugs.com. 39% of reviewers reported a positive effect, while 50% reported a negative effect. Farxiga has an average rating of 4.5 out of 10 from a total of 146 ratings on Drugs.com.
Heart failure can progress, so researchers have identified four stages of the disease — A, B, C and D. Health care professionals also classify heart failure when it has progressed to stages C and D. This classification measures a patient's overall heart function and severity of symptoms.
If it's due to a heart valve problem that gets addressed or an arrhythmia that's controlled, ejection fraction can return to normal. If heart failure is caused by alcohol or other substance use, stopping use of those substances can reverse heart failure, too.
Thus, in clinical practice, patients without contraindications appear to gain most benefit from combined treatment with the 'fantastic four': an ARNI, a beta-blocker, an MRA, and an SGLT2 inhibitor (Figure 1).
What is the injection for heart failure?
Dobutamine injection. Dobutamine is a medication that treats heart failure by strengthening your heart muscle. Heart failure happens when your heart isn't pumping very well. A healthcare provider will give you this injection in a hospital or clinic setting.
The mainstay of medical treatment for patients with heart failure with reduced ejection fraction (HFrEF) are beta blockers (BB), angiotensin converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA).
When euvolaemia is achieved, diuretics may be stopped or flexibly used in conjunction with a heart failure action plan in selected patients, allowing for further up-titration of the proven guideline-directed therapies. Furosemide (frusemide) is typically the first-line diuretic.
Studies in the past 2 years have demonstrated that we can induce remissions in this malignant process if therapy is instituted rapidly, at the first acute heart failure episode, using full doses of all available effective medications.
The term “congestive” refers to the resulting buildup of fluid in the ankles and feet, arms, lungs, and/or other organs. Almost 6 million Americans have congestive heart failure. However, with the correct treatment, patients can recover to good health.
References
- https://diatribe.org/fda-approves-inpefa-first-dual-heart-failure-medication
- https://emedicine.medscape.com/article/163062-medication
- https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/647336
- https://blog.bswhealth.med/four-pillars-of-heart-failure-therapy-should-be-rapidly-and-simultaneously-introduced/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722345/
- https://www.ahajournals.org/doi/10.1161/JAHA.123.031745
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/congestive-heart-failure-prevention-treatment-and-research
- https://my.clevelandclinic.org/health/drugs/18471-dobutamine-injection
- https://my.clevelandclinic.org/health/treatments/23528-heart-failure-medications
- https://www.yalemedicine.org/departments/heart-transplant-and-left-ventricular-assist-device-program
- https://www.ema.europa.eu/en/documents/overview/entresto-epar-summary-public_en.pdf
- https://www.medicalnewstoday.com/articles/321538
- https://www.yalemedicine.org/conditions/congestive-heart-failure
- https://www.drugs.com/compare/entresto-vs-farxiga
- https://nortonhealthcare.com/news/how-long-you-can-live-with-heart-failure-depends-on-many-factors-lifestyle-stage-of-the-condition-and-more/
- https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/classes-of-heart-failure
- https://hfsa.org/fda-approves-new-treatment-type-heart-failure
- https://www.boehringer-ingelheim.com/us/press-release/us-fda-approves-jardiance-empagliflozin-treat-adults-living-heart-failure-reduced
- https://www.uptodate.com/contents/drugs-that-should-be-avoided-or-used-with-caution-in-patients-with-heart-failure
- https://academic.oup.com/eurheartj/article/42/6/681/6099035
- https://www.formularywatch.com/view/fda-approves-first-anti-inflammatory-drug-for-cardiovascular-disease
- https://health.osu.edu/health/heart-and-vascular/can-you-reverse-heart-failure
- https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-type-heart-failure
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768868/
