The Living Guidelines: Patients with Heart Failure who have Concomitant Disorders. Suggest Revisions to the CLASS I Guidelines

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Class I Guidelines
1. All other recommendations should apply to patients with concomitant disorders unless there are specific exceptions. (Level of Evidence C)

2. Physicians should control systolic and diastolic hypertension and diabetes mellitus in patients with HF in accordance with recommended guidelines. (Level of Evidence: C)

3. Physicians should use nitrates and beta-blockers for the treatment of angina in patients with HF. (Level of Evidence: B)

4. Physicians should recommend coronary revascularization according to recommended guidelines in patients who have both HF and angina. (Level of Evidence: A)

5. Physicians should prescribe anticoagulants in patients with HF who have paroxysmal or persistent atrial fibrillation or a previous thromboembolic event. (Level of Evidence: A)

6. Physicians should control the ventricular response rate in patients with HF and atrial fibrillation with a beta-blocker (or amiodarone, if the beta-blocker is contraindicated or not tolerated). (Level of Evidence: A)

7. Patients with coronary artery disease and HF should be treated in accordance with recommended guidelines for chronic stable angina. (Level of Evidence: C)

8. Physicians should prescribe antiplatelet agents for prevention of MI and death in patients with HF who have underlying coronary artery disease. (Level of Evidence: B)