The Living Guidelines: Patients with Cardiac Structural Abnormalities or Remodeling who have not Developed Heart Failure Symptoms. Polling Results for CLASS I Guidelines

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Class I Guidelines
1. All Class I recommendations for Stage A should apply to patients with cardiac structural abnormalities who have not developed HF. (Levels of Evidence: A, B, and C as appropriate)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 1 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III 2. Beta-blockers and ACEIs should be used in all patients with a recent or remote history of MI regardless of EF or presence of HF. (Level of Evidence: A)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 2 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III 3. Beta-blockers are indicated in all patients without a history of MI who have a reduced LVEF with no HF symptoms. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 3 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III 4. Angiotensin converting enzyme inhibitors should be used in patients with a reduced EF and no symptoms of HF, even if they have not experienced MI. (Level of Evidence: A)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 4 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III 5. An ARB should be administered to post-MI patients without HF who are intolerant of ACEIs and have a low LVEF. (Level of Evidence: B)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 5 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III 6. Patients who have not developed HF symptoms should be treated according to contemporary guidelines after an acute MI. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 6 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III 7. Coronary revascularization should be recommended in appropriate patients without symptoms of HF in accordance with contemporary guidelines (The Living Guidelines: Chronic Stable Angina Pectoris). (Level of Evidence: A)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 7 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III 8. Valve replacement or repair should be recommended for patients with hemodynamically significant valvular stenosis or regurgitation and no symptoms of HF in accordance with contemporary guidelines. (Level of Evidence: B)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class I Recommendation 8 for patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms should be: CLASS I CLASS IIa CLASS IIb CLASS III