Table 9. Recommendations for Treatment of Stage B HF
Recommendations
COR
LOE
In patients with a history of MI and reduced EF, ACE inhibitors
or ARBs should be used to prevent HF
I
A
In patients with MI and reduced EF, evidence-based beta blockers
should be used to prevent HF
I
B
In patients with MI, statins should be used to prevent HF
I
A
Blood pressure should be controlled to prevent symptomatic HF
I
A
ACE inhibitors should be used in all patients with a reduced EF
to prevent HF
I
A
Beta blockers should be used in all patients with a reduced EF to
prevent HF
I
C
An ICD is reasonable in patients with asymptomatic ischemic
cardiomyopathy who are ≥40 days post-MI, have an LVEF ≤30%,
and are on GDMT
IIa
B
Nondihydropyridine calcium channel blockers may be harmful in
patients with low LVEF
III:
Harm
C
Table 10. Other ACCF/AHA Guidelines Addressing Stage B
Patients
Considerations
Reference
Patients with an acute MI who have not
2013 UA/NSTEMI Guideline
developed HF symptoms treated according 2013 STEMI Guideline
to GDMT
Coronary revascularization for patients
without symptoms of HF in accordance
with GDMT
2011 PCI Guideline
2011 CABG Guideline
2012 SIHD Guideline
Valve replacement or repair for patients
with hemodynamically significant valvular
stenosis or regurgitation and no symptoms
of HF in accordance with GDMT
2008 Focused Update incorporated into
the 2006 VHD Guideline
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