2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (with 2023 Focused Update)
The 2021 ESC heart-failure guideline established the four foundational drug classes for HFrEF (ARNI/ACE inhibitor, beta-blocker, MRA and SGLT2 inhibitor), and the 2023 Focused Update extended SGLT2 inhibitors across the whole ejection-fraction spectrum. This page groups the register's landmark trials by the guideline's themes — foundational therapy, HFpEF, devices and advanced HF.
This guideline cites 26 of the 199 landmark trials in our Cardiology register.
Foundational HFrEF therapy (four pillars)11
- 2020EMPEROR-ReducedCardiology · HF · SGLT2 inhibitorsEmpagliflozin Outcome Trial in Chronic Heart Failure With Reduced EF
- 2019DAPA-HFCardiology · HF · SGLT2 inhibitorsDapagliflozin and Prevention of Adverse outcomes in Heart Failure
- 2014PARADIGM-HFCardiology · HF · ARNIProspective comparison of ARNI with ACEI to Determine Impact on Global Mortality
- 2011EMPHASIS-HFCardiology · HF · MRAEplerenone in Mild Patients Hospitalisation and Survival Study in Heart Failure
- 2004A-HeFTCardiology · HF · hydralazine/nitrateAfrican-American Heart Failure Trial
- 2003CHARMCardiology · HF · ARBCandesartan in Heart failure: Assessment of Reduction in Mortality and morbidity — Overall Programme
- 2001COPERNICUSCardiology · HF · beta-blockerCarvedilol Prospective Randomized Cumulative Survival Study
- 1999RALESCardiology · HF · MRARandomized Aldactone Evaluation Study
- 1999MERIT-HFCardiology · HF · Beta-blockadeMetoprolol CR/XL Randomized Intervention Trial in Heart Failure
- 1991SOLVDCardiology · HF · ACE inhibitorStudies of Left Ventricular Dysfunction — Treatment Trial
- 1987CONSENSUSCardiology · HF · RAAS inhibitionCooperative North Scandinavian Enalapril Survival Study
HFmrEF & HFpEF3
- 2022DELIVERCardiology · HF · SGLT2 inhibitorsDapagliflozin Evaluation to Improve the Lives of Patients with Preserved-EF Heart Failure
- 2021EMPEROR-PreservedCardiology · HF · SGLT2 inhibitorsEmpagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved EF
- 2014TOPCATCardiology · HF · MRATreatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist
Adjunctive & advanced HFrEF5
- 2022STRONG-HFCardiology · HF · GDMT up-titrationSafety, Tolerability and Efficacy of Rapid Optimization, helped by NT-proBNP testinG, of Heart Failure therapies
- 2020VICTORIACardiology · HF · sGC stimulatorVericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction
- 2019PIONEER-HFCardiology · HF · ARNIComparison of Sacubitril/Valsartan versus Enalapril on Effect on NT-proBNP in Patients Stabilized from an Acute Heart Failure Episode
- 2016STICHCardiology · HF · CABGSurgical Treatment for Ischemic Heart Failure — Extension Study (STICHES, 10-year follow-up)
- 2010SHIFTCardiology · HF · If-channel inhibitorSystolic Heart failure treatment with the If inhibitor ivabradine Trial
Device therapy — ICD & CRT7
- 2016DANISHCardiology · Arrhythmia · ICDDanish Study to Assess the Efficacy of ICDs in Non-Ischaemic Systolic Heart Failure
- 2010RAFTCardiology · Arrhythmia · CRTResynchronization-Defibrillation for Ambulatory Heart Failure Trial
- 2009MADIT-CRTCardiology · Arrhythmia · CRTMulticenter Automatic Defibrillator Implantation Trial with CRT
- 2005CARE-HFCardiology · Arrhythmia · CRTCardiac Resynchronisation in Heart Failure
- 2005SCD-HeFTCardiology · Arrhythmia · ICDSudden Cardiac Death in Heart Failure Trial
- 2004COMPANIONCardiology · Arrhythmia · CRTComparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure
- 2002MADIT-IICardiology · Arrhythmia · ICDMulticenter Automatic Defibrillator Implantation Trial II
Published since the guideline1
- 2024FINEARTS-HFCardiology · HF · MRAFinerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction