1. Choose display

Estimate patient risk (click to expand/collapse)

Your current location
Sex
NYHA functional class
Prior heart failure hospitalization
Diabetes
Prior stroke or peripheral artery disease
Age (years)
 
Systolic BP (mmHg)
 
NT-proBNP (ng/L)
 
Ejection fraction (%)
 
eGFR (mL/min/1.732)
 
Current heart failure medications
2. Know the risks of heart failure:
2. Know the benefits & harms of treatment:

5-year survival with no medications:

50%
50 Alive
50 Not alive
A. Heart failure shortens life expectancy.
On average for people with heart failure not taking any medications, 50 in 100 people will still be alive in 5 years.

5-year survival with current medication(s):

20%
80 Alive
20 Not alive

5-year survival with additional medication(s):

20%
80 Alive (with or without additional medications)
20 Not alive (with or without additional medications)

5-year survival with additional medication(s):

50%
50 Alive (with or without additional medications)
50 Not alive (with or without additional medications)
A. Heart failure shortens life expectancy. Your life expectancy:
With no medication: Age 83 years
With current medications: Age 83 years
A. Your life expectancy:
With current medications: Age 83 years
With additional medications: Age 83 years (+0 extra years added to your life)
B. Heart failure increases the risk of being hospitalized.
On average for people with heart failure on no medications, 15 in 100 people will be hospitalized with heart failure each year.
B. Your risk of hospitalization for heart failure in the next year:
No medication: 15 in 100
With current and additional medications: 15 in 100

C. Heart failure causes progressively worsening symptoms that limit quality of life.

C. Quality of life: 

With additional medications, 0 more people out of 100 will feel noticeably better.

3. Choose additional medication(s) to discuss
Choose an option to discuss 

(click arrow in each button to see side-effects, costs, and routine)

Choose an option to discuss

(click arrow in each button to see side-effects, costs, and routine)

What's included in the combination?ARNI (sacubitril-valsartan), a beta-blocker (e.g. bisoprolol), an MRA (e.g. spironolactone), and an SGLT2i (e.g. dapagliflozin)
Side-effects15 people out of 100 will develop lightheadedness, cough, genital yeast infection, breast growth/tenderness [spironolactone only], or bloodwork requiring medication changes
0.2 people out of 100 will develop angioedema
Less than 0.1 person out of 100 will develop euglycemic diabetic ketoacidosis
Monthly cost (without drug coverage)About $300 to $370
Lower cost: Bisoprolol/metoprolol & spironolactone
Higher cost: Carvedilol & eplerenone
RoutineThree pills once a day, one pill twice a day
What's included in the combination?ACEI or ARB (e.g. ramipril or candesartan), a beta-blocker (e.g. bisoprolol), an MRA (e.g. spironolactone), and an SGLT2i (e.g. dapagliflozin)
Side-effects10 people out of 100 will develop lightheadedness, cough, genital yeast infection, breast growth/tenderness [spironolactone only], or bloodwork requiring medication changes
0.2 people out of 100 will develop angioedema (ACEI only)
Less than 0.1 person out of 100 will develop euglycemic diabetic ketoacidosis
Monthly cost (without drug coverage)About $60 to $130
Lower cost: Bisoprolol/metoprolol & spironolactone
Higher cost: Carvedilol & eplerenone
RoutineFour pills once a day
What's included in the combination?ACEI or ARB (e.g. ramipril or candesartan), a beta-blocker (e.g. bisoprolol), and an MRA (e.g. spironolactone)
Side-effects10 people out of 100 will develop lightheadedness, cough, breast growth/tenderness [spironolactone only], or bloodwork requiring medication changes
0.2 people out of 100 will develop angioedema (ACEI only)
Monthly cost (without drug coverage)About $30 to $105
Lower cost: Bisoprolol/metoprolol & spironolactone
Higher cost: Carvedilol & eplerenone
RoutineThree pills once a day
Side-effects5 people out of 100 will develop lightheadedness, fainting, or bloodwork requiring medication changes
Monthly cost (without drug coverage)About $250
RoutineOne pill two times a day
Side-effects1 to 5 person out of 100 will develop lightheadedness, fainting, cough [ACEI only], or bloodwork requiring medication changes
0.2 people out of 100 will develop angioedema (ACEI only)
Monthly cost (without drug coverage)About $10
RoutineOne pill once a day (sometimes two times a day)
Side-effects1 to 5 people out of 100 will develop side-effects (lightheadedness, diarrhea, or claudication-type leg pain)
Monthly cost (without drug coverage)Bisoprolol/metoprolol: About $10
Carvedilol: About $20
RoutineBisoprolol: One pill once a day; Carvedilol/metoprolol: One pill two times a day
Side-effects1 to 5 people out of 100 will develop breast growth/tenderness [spironolactone only] or bloodwork requiring medication changes
Monthly cost (without drug coverage)Spironolactone: About $10
Eplerenone: About $80
RoutineOne pill once a day
Side-effects1 to 5 people out of 100 will develop genital yeast infection or bloodwork requiring medication changes
Less than 0.1 person out of 100 will develop euglycemic diabetic ketoacidosis
Monthly cost (without drug coverage)About $30
RoutineOne pill once a day
RELATIVE RISK - CV DEATH
ACEI
0.82
ARNI vs. ACEI
0.8
ARNI vs. Placebo
0.66
Beta-blocker
0.65
MRA
0.72
SGLT2i
0.86
RELATIVE RISK - HEART FAILURE HOSPITALIZATION
ACEI
0.64
ARNI vs. ACEI
0.79
ARNI vs. Placebo
0.51
Beta-blocker
0.64
MRA
0.63
SGLT2i
0.69
QUALITY OF LIFE IMPROVEMENT
ACEI
0.05
ARNI vs. Placebo
0.1
ARNI vs. ACEI
0.05
Beta-blocker
0
MRA
0.05
SGLT2i
0.05
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