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    Quiz: 2017 ACC/AHA/HFSA Update to 2013 HF Guidelines


    The correct answer is: D. Neither A or B 

    According to 2017 ACC/AHA/HFSA updated HF management guidelines, concomitant administration of an ACE-I and ARNI (or administering an ARNI <36 hours after stopping an ACE-I) is not recommended, based on the risk for for angioedema. Likewise, a patient with a history of angioedema should not receive an ARNI due to this risk. In patients with HFrEF NYHA class II or III who remain symptomatic despite tolerating an ACE-I or an ARB, ACC/AHA/HFSA recommends replacement with an ARNI. New clinical trial data suggests that replacing an ACE-I or ARB with an ARNI may decrease hospitalizations and mortality in such patients.    



    1. Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2017 Aug 8;136(6):e137-e161. doi: 10.1161/CIR.0000000000000509.

    2. Wright JT Jr, Williamson JD, Whelton PK, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103–16.


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