Table 3.8-1. The ACC/AHA stages of heart failure

Stage A: At-risk for HF

– At risk for HF but with no current or previous symptoms or signs of HF and with no structural or functional heart disease or abnormal biomarkers

– Hypertension, cardiovascular disease, diabetes mellitus, obesity, exposure to cardiotoxic agents, genetic variant for cardiomyopathy, family history of cardiomyopathy

Stage B: Pre-HF

No current or previous symptoms or signs but with evidence of 1 of the following:

– Structural heart disease

– Evidence of increased filling pressures

– Risk factors and increased natriuretic peptide levels or persistently elevated cardiac troponin levels in the absence of competing diagnoses

Stage C: Symptomatic HF

Current or previous symptoms or signs of HF

Stage D: Advanced HF

Marked symptoms of HF that interfere with daily life, with recurrent hospitalizations despite attempts to optimize GDMT

Adapted from J Card Fail. 2022 May;28(5):e1-e167.

ACC, American College of Cardiology; AHA, American Heart Association; GDMT, guideline-directed medical therapy; HF, heart failure.