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. 2024 Jul 14;76(4):229–239. doi: 10.1016/j.ihj.2024.07.005

Table 4.

Guideline recommendations for SGLT2i and ARNI for the Treatment of Heart Failure.

HF category SGLT2i
ARNI
Recommendations of ACC/AHA guidelinesa Recommendation of ESC guidelinesb Recommendations of ACC/AHA guidelinesa Recommendation of ESC guidelinesb
HFrEF (LVEF ≤40 %) 1 1 1 1
HFmrEF (LVEF 41–49 %) 2a 1 2b 2b
HFpEF (LVEF≥50 %) 2a 1 2b Currently no recommendations
HFimpEF (previously LVEF ≤40 % now EF>40 %) 1 (Continue and optimize GDMT) Currently no recommendations 1 (Continue and optimize GDMT) Currently no recommendations

Note:- HF: heart failure; HFrEF: Heart failure with reduced ejection fraction; HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mildly reduced ejection fraction; HFimpEF: heart failure with improved ejection fraction; SGLT2i: sodium-glucose co-transporter 2 inhibitor, ARNI: angiotensin receptor-neprilysin inhibitor, GDMT: guideline-directed medical therapy.

a

2022 AHA (American Heart Association)/ACC (American College of Cardiology)/HFSA (Heart Failure Society of America) Guideline for the Management of Heart Failure.

b

2023 Focused Update of the 2021 ESC (European Society of Cardiology) Guidelines for the diagnosis and treatment of acute and chronic heart failure.