To Members of the Heart Failure Society of America:
Thanksgiving is almost here and while we remember those who either succumbed to COVID-19 or are still experiencing the consequences of their infection, we have much to be thankful for in our battle against this powerful adversary. Scientific advances have yielded an increasing number of effective strategies including monoclonal antibodies, vaccines, and, most recently, oral antiviral compounds. Of course, much remains to be done to ensure that all parts of the world can reap the benefits of these advances. Nevertheless, our toolbox is increasingly full, and I am more optimistic than ever that we have turned the corner in the pandemic. My hope is that all of you will pause during the Thanksgiving holiday to appreciate these advances and the many people who made them possible, including the basic scientists, clinical trialists, participants in the clinical trials, and our industry partners.
Just as with the advances against COVID-19, the heart failure community also has much to be thankful for given the many new therapies that have emerged in our field. For years after triple therapy (ACE inhibitors/Angiotensin Receptor Blockers, Beta-blockers, Mineralocorticoid Receptor Antagonists) was established for patients with HFrEF, we watched one negative trial after another be announced. And then, finally, things changed. Sacubitril-valsartan was shown to be superior to ACE inhibition, and, most recently, SGLT2 inhibition emerged as a novel therapeutic approach. The latter even was effective in patients with HFpEF in a large clinical trial, a first-time event for this challenging condition. Other therapies for patients with HFrEF, including vericiguat and omecamtiv mecarbil, while not prolonging survival, also exerted favorable actions in large clinical trials. In aggregate, this suite of novel effective therapies is remarkable, and, as with COVID-19, expands our therapeutic armamentarium in the battle against heart failure.
It is against this backdrop that I believe it worthwhile to consider just how much had to go right to bring these medications to the clinical arena. These agents would not be available had they not made it through drug development, preclinical studies, and ultimately large, well-conducted clinical trials which require great expense and thousands of people willing to subject themselves to randomization. So many compounds fail during this multistep process, and, yet, these therapies succeeded. This perspective is one reason it is so disappointing that recent data show shockingly low utilization rates of the prior standard of care (triple therapy) for patients with HFrEF in the United States.
We, at the HFSA, are committed to improving this situation. In that spirit, we recently launched the Optimal Medical Therapy (OMT-HF) certificate program geared for clinicians involved in the care of patients with heart failure. The program consists of three online modules followed by an exam which, when completed successfully, culminates in awarding of a certificate. OMT-HF highlights recommended pharmacological therapies, as well as their target doses. Our intent is to close the unacceptable gaps in deployment of guideline-directed medical therapy, thereby benefiting the many patients who suffer unfortunate consequences by not receiving therapies which can reduce morbidity and increase survival.
Who should participate in this program? We believe all clinicians who manage patients with heart failure, except perhaps those who are ABIM-certified in advanced heart failure/transplant cardiology, could benefit. Whether you are a nurse practitioner, physician assistant, general cardiologist, internist, hospitalist, or family practice physician, if you treat patients with heart failure, I suggest you consider OMT-HF to gain additional insights to ensure your patients are receiving the very best care available. By the mere fact that you are reading this email from the HFSA, I know you already have a strong interest and commitment to helping patients with heart failure, a goal closely aligned with OMT-HF. For those interested in learning more, please click here.
As always, I welcome your feedback either about OMT-HF or any other matter related to the field of heart failure broadly, or, more specifically, the HFSA.
Wishing all a wonderful Thanksgiving holiday!
Mark H. Drazner, MD, MSc, FHFSA
HFSA President 2021-2022