Terapia farmacológica de la insuficiencia cardíaca con fracción de eyección reducida

Abstract

OBJECTIVE: The present investigation seeks to establish pharmacological therapy for heart failure with reduced ejection fraction based on current evidence in order to improve comprehensive care and reduce morbidity and mortality of affected patients. METHODOLOGY: A bibliographic review was carried out where updated articles related to HFrEF within quartile 1 were selected along with the main clinical practice guidelines. RESULTS: The diagnosis of HFrEF includes the presence of symptoms and signs of HF, echocardiography with determination of LVEF and elevation of BNP or NT-proBNP. The treatment was developed based on the patient's LVEF, and currently the treatment of choice is the simultaneous initiation of four drugs that have been shown to affect NYHA functional class, morbidity and mortality, and the risk of hospitalization. The first line being ARNI/ACE-I/BRA II, beta-blockers, mineralocorticoid antagonist and SGLT2 inhibitors. CONCLUSION: Early diagnosis and treatment of HFrEF achieves a better quality of life for the patient. Guideline-guided therapy with initial doses and appropriate titration is associated with a better prognosis and lower risk of decompensation.