We are all aware of the role of ACE inhibitors and Angiotensin-II blockers in managing chronic heart failure and how B-blockers went from HF bad boy to recommended therapy, led largely by Carvedilol.
Spironolactone has become an established part of therapy following the publication of the RALES trial waaay back in 1999, with mortality and morbidity benefits and decreased frequency of hospital admission for acute exacerbations of chronic heart failure. Other aldosterone receptor blocking agents have been added to the mix, with agents like Eplerenone (EMPHASIS-HF, NEJM 2011 - a trial that was stopped early when a pre-planned threshold had been crossed. Watch out!) looking similarly promising, though you need to be aware of the inclusion and exclusion criteria.
So what's new in heart failure management?