|Heart Failure Population||Recommendation||Class||Level of Evidence|
|Initial evaluation||Initial laboratory evaluation with serum lipid profile||I||C|
|Coronary arteriography should be performed in patients presenting with HF who have angina or significant ischemia unless the patient is not eligible for revascularization of any kind.||I||C|
|Coronary arteriography is reasonable for patients presenting with HF who have chest pain that may or may not be of cardiac origin who have not had evaluation of their coronary anatomy and who have no contraindications to coronary revascularization.||IIA||C|
|Coronary arteriography is reasonable for patients presenting with HF who have known or suspected coronary artery disease but who do not have angina unless the patient is not eligible for revascularization of any kind.||IIA||C|
|Noninvasive imaging to detect myocardial ischemia and viability is reasonable in patients presenting with HF who have known coronary artery disease and no angina unless the patient is not eligible for revascularization of any kind.||IIA||B|
|Noninvasive imaging may be considered to define the likelihood of coronary artery disease in patients with HF and LV dysfunction.||IIB||C|
|In patients at high risk for developing HF, lipid disorders should be treated in accordance with contemporary guidelines.||I||A|
|In patients at high risk for developing HF who have known atherosclerotic vascular disease, health care providers should follow current guidelines for secondary prevention.||I||C|
|Coronary revascularization should be recommended in appropriate patients without symptoms of HF in accordance with contemporary guidelines.||I||A|
|Coronary revascularization is reasonable in patients with HF and normal LVEF and coronary artery disease in whom symptomatic or demonstrable myocardial ischemia is judged to be having an adverse effect on cardiac function.||IIA||C|
|Statins are not beneficial as adjunctive therapy when prescribed solely for the diagnosis of HF in the absence of other indications for their use.||III||A|
|Physicians should recommend coronary revascularization according to recommended guidelines in patients who have both HF and angina||I||A|
|HF with concomitant disorders||Physicians should prescribe antiplatelet agents for prevention of MI and death in patients with HF who have underlying coronary artery disease.||I||B|
|Patients with coronary artery disease and HF should be treated in accordance with recommended guidelines for chronic stable angina.||I||C|
- Ambrosy A.P.
- Vaduganathan M.
- Mentz R.J.
- et al.
Is Coronary Artery Disease a Target for Therapy in Heart Failure?
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Conflicts of Interest: GCF: Research Support: NIH (significant), AHRQ (significant); Consultant: Novartis (significant), Medtronic (modest), Bayer (modest), Gambro (modest), Janssen (modest). JB: Research Support: National Institutes of Health, European Union, Health Resource Services Administration, Food and Drug Administration; Consultant: Amgen, Bayer, Celladon, Gambro, GE Healthcare, Janssen, Medtronic, Novartis, Ono, Relypsa, Trevena. MG: Consultant: Abbott Labs, Astellas, AstraZeneca, Bayer Schering PharmaAG, CorThera Inc., Cytokinetics Inc., DebioPharm S.A., Errekappa Terapeutici (Milan, Italy), Glaxo Smith Kline, JNJ, Medtronic, Novartis Pharma AG, Otsuka, Sigma Tau, Solvay Pharmaceuticals, and Pericor Therapeutics. The rest of the authors disclose no conflicts of interest related to this work.
Authorship: All authors had access to the data and a role in writing the manuscript.