The use of ESAs to treat anemia is associated with a higher risk for adverse thromboembolic events and therefore cannot be currently recommended in patients with HF and anemia. Rather, therapy should target the underlying cause of the anemia, such as iron deficiency.
Although it is true that beta-blockers are contraindicated in other pulmonary diseases, selective beta-blockers can be used in patients with COPD and co-occurring HF. Three US Food and Drug Administration–indicated beta-blockers for use in HFrEF — carvedilol, metoprolol succinate, and bisoprolol — have been shown to significantly reduce morbidity and mortality in patients with diabetes.
Systemic corticosteroids may cause sodium and water retention, but inhaled corticosteroids are not associated with such effects in patients with HF and COPD.
Thiazolidinediones have been shown to increase the risk for adverse HF-related events and have been contraindicated in patients with chronic HF. As of now, there is no evidence that DPP-4 inhibitors provide cardiovascular benefit; in fact, in patients with diabetes at high cardiovascular risk, some DPP-4 inhibitors could increase the risk for hospitalization for HF.
For additional information, refer to the following clinical practice guidelines:
2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America
2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure)
European Society of Cardiology (ESC) Acute and Chronic Heart Failure Guidelines
Learn more about the workup of HF.
Medscape © 2021 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Ioana Dumitru. Fast Five Quiz: Heart Failure Comorbidities - Medscape - Jul 15, 2021.