The following are key points to remember from the 2023 Focused Update of the 2021 European Society of Cardiology (ESC) Guidelines for the diagnosis and treatment of acute and chronic heart failure:

1. This 2023 Focused Update addresses changes in recommendations for the treatment of heart failure (HF) because of availability of new evidence.
2. A sodium–glucose co-transporter 2 (SGLT2) inhibitor (dapagliflozin or empagliflozin) is recommended in patients with HF with mildly reduced ejection fraction (HFmrEF) to reduce the risk of HF hospitalization or cardiovascular (CV) death (Class I, level of evidence [LOE] A).
3. An SGLT2 inhibitor (dapagliflozin or empagliflozin) is recommended in patients with HF with preserved EF (HFpEF) to reduce the risk of HF hospitalization or CV death (Class I, LOE A).
4. An intensive strategy of initiation and rapid up-titration of evidence-based treatment before discharge and during frequent and careful follow-up visits in the first 6 weeks following an HF hospitalization is recommended to reduce the risk of HF rehospitalization or death (Class I, LOE B).
5. In patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), SGLT2 inhibitors (dapagliflozin or empagliflozin) are recommended to reduce the risk of HF hospitalization or CV death (Class I, LOE A).
6. In patients with T2DM and CKD, finerenone is recommended to reduce the risk of HF hospitalization (Class I, LOE A).
7. Intravenous iron supplementation is recommended in symptomatic patients with HF with reduced EF (HFrEF) and HFmrEF, and iron deficiency, to alleviate HF symptoms and improve quality of life (Class I, LOE A).
8. Intravenous iron supplementation with ferric carboxymaltose or ferric derisomaltose should be considered in symptomatic patients with HFrEF and HFmrEF, and iron deficiency, to reduce the risk of HF hospitalization (Class IIA, LOE A).

Clinical Topics: Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure

Keywords: Acute Heart Failure, Anemia, Iron-Deficiency, Diabetes Mellitus, Type 2, ESC Congress, ESC23, Heart Failure, Patient Discharge, Patient Readmission, Quality of Life, Renal Insufficiency, Chronic, Secondary Prevention, Sodium-Glucose Transporter 2 Inhibitors, Stroke Volume

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