A range of new guidelines for preventing and treating cardiovascular disease have been unveiled at a major European conference this weekend.
A special edition of the European Heart Journal contains detailed guidance on risk in patients with diabetes, heart failure, acute coronary syndromes, cardiomyopathies and cardiac imaging.
The guidance was also unveiled at the conference of the European Society of Cardiology in Amsterdam.
The diabetes guidance focuses on lifestyle changes but also recommends SGLT2 inhibitors and/or GLP-1 receptor agonists to reduce cardiovascular risk and includes a special section on heart failure care.
The heart failure guidance has been updated to include the latest evidence supporting the use of SGLT2 inhibitors in certain patients. They also call for intensive strategies of beginning evidence-based treatment before hospital discharge and during “frequent” follow up visits.
Leader of the guidelines development Professor Marco Metra, of the University of Brescia, Italy, said: “In 2021, the ESC published Guidelines for the diagnosis and treatment of acute and chronic heart failure. Since then, more than ten randomised controlled trials have been released that should change patient management ahead of the next scheduled full guideline, necessitating a focused update.”
The guidance on acute coronary syndromes calls for supervised cardiac rehabilitation programmes to include encouragement of healthy lifestyles. They include a new section on the care of patients with cancer and suggest invasive treatments, such as the use of stents, where patients have expected survival of more than six months.
The European Society of Cardiology says the cardiomyopathy guidance is the first global guidance to include all subtypes and the first to include recommendations for conditions other than hypertrophic cardiomyopathy. They have a special focus on inherited conditions and the need for genetic counselling.
Developer Dr Juan Pablo Kaski, of University College London, UK, said: “At the core of this new guideline are patients and their families, starting from the point at which an individual presents with symptoms, or as an incidental finding or because of a family history, and working through the pathway towards making a diagnosis and starting treatment.”
A statement on cardiac imaging focuses on clinical competencies, says that cardiologists’ “deep understanding” of cardiovascular disease puts them in a unique position to select the most appropriate imaging tests.
The cardiologists say they are concerned that expertise in radiology is being developed without reference to the “integral role” of cardiologists.
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