Heart health
ACC issues guidance on HFpEF, frailty and myocardial infarction
The new guidance covers HFpEF diagnosis and treatment, screening for frailty and cognitive impairment, and updated MI classification.
The ACC has issued new cardiovascular guidance covering heart failure with preserved ejection fraction (HFpEF), frailty and cognitive impairment, and myocardial infarction (MI). Its 2026 HFpEF pathway describes the condition as a multisystem syndrome and offers a structured approach to diagnosis and treatment. It includes guidance on medicines such as SGLT2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists and incretin-based therapies.
A new scientific statement calls for routine, feasible screening for frailty and cognitive impairment in outpatient settings and after hospitalization. The Fifth Universal Definition of MI, released on behalf of a joint task force including the ACC, sets out three clinical categories: Primary MI, Secondary MI and Procedure-related MI. It also updates criteria for myocardial injury, includes sex-specific cardiac troponin thresholds and introduces accelerated diagnostic pathways using high-sensitivity cardiac troponin assays.
