Advances in pharmacotherapy for heart failure and reduced ejection fraction: what's new in 2024?

Expert Opin Pharmacother. 2024 Oct;25(14):1887-1902. doi: 10.1080/14656566.2024.2408376. Epub 2024 Oct 3.

Abstract

Introduction: Updated guidelines for heart failure with reduced ejection fraction (HFrEF) and acute decompensation have improved outcomes, but ongoing efforts are focused on uncovering new evidence and developing novel therapies. This review examines the limitations of current treatments and the potential impact of emerging therapies.

Areas covered: A literature search focused on studies investigating drugs for HFrEF. We review recent clinical trials and emerging therapies to assess evidence strength, explore guideline updates, and identify strategies to optimize patient outcomes.

Expert opinion: The HFrEF treatment landscape is rapidly evolving, with advances in therapies like sodium/glucose cotransporter inhibitors and sacubitril-valsartan. Though managing acute decompensated heart failure remains challenging, recent trials suggest improvements in diuretic strategies and anti-inflammatory treatments. Ongoing research is essential for validating these therapies and incorporating them into standard practice.

Keywords: Acute decompensated heart failure; Glucagon-like peptide-1 receptor antagonist; Iron; Sodium/Glucose cotransporter 2 inhibitor; Vericiguat; angiotensin receptor neprilysin inhibitors; heart failure with reduced ejection fraction; vitamin D.

Publication types

  • Review

MeSH terms

  • Aminobutyrates / therapeutic use
  • Biphenyl Compounds / therapeutic use
  • Cardiovascular Agents / therapeutic use
  • Drug Combinations
  • Drug Development
  • Heart Failure* / drug therapy
  • Heart Failure* / physiopathology
  • Humans
  • Practice Guidelines as Topic
  • Stroke Volume* / drug effects
  • Valsartan / therapeutic use

Substances

  • Drug Combinations
  • Aminobutyrates
  • sacubitril and valsartan sodium hydrate drug combination
  • Valsartan
  • Biphenyl Compounds
  • Cardiovascular Agents