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[Both, mortality and morbidity of chronic heart failure are persistently high, thus its adequate disease management is of pre-eminent importance. For heart failure with reduced ejection fraction (HFrEF) numerous evidence are available to improve its prognosis, including reduction of mortality, sudden cardiac death, and hospitalizations. Large randomized clinical trials have been shown that angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin-receptor/neprilysin inhibitor (ARNI), B-blockers, mineralocotricoid receptor antagonists (MRAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) reduce both morbidity and mortality of HFrEF patients. Accordingly, the heart failure recommendation of the European Society of Cardiology (ESC) issued 2021, proposed the basic therapy for HFrEF in 4 pillars: ACEI/ARNI, BB, MRA and SGLT2 inhibitors. 
Instead of the earlier approach of stepwise sequential therapy, the new recommendation advocates for simultaneous initiation of all four drug classes with rapid titration to the target dose. The STRONG-HF clinical trial aimed to compare the rapid titration with its conventional strategy. Con­cer­ning the primary composite endpoint of re­peated heart failure in 180 days with rehospitalization and all-cause mortality compared with changes in quality of life and re­hospitalization by heart failure as separate endpoints, the rapid titration was significantly more efficient solution. 
When optimizing therapy, we have also to pay attention to the comorbidities of HFrEF patients, which may compromise the procedure of titration. The consensus document of the ESC Heart Failure Association recommends special patient profiling by comorbidities and specific hemodynamic parameters, followed by therapeutic re­com­mendations on different patient profiles. Overall, SGLT2 inhibitors have the least limiting factors and contraindications, thus they can be used in all profiles without exception – as early as at initiating the therapy.]

[Type 2 diabetes mellitus, as well as depression and anxiety, are generally prevalent and often occur together. Their relationship is complex with impacts of common aetiological factors, such as genetic background, activation of the stress system and the sympathetic nervous system, dysfunction of the immune system and elevated inflammatory cytokines, changes in the central nervous system, as well as lifestyle and socioeconomic factors. On the other hand, their relationship of the three conditions are bidirectional: diabetes may increase the risk of developing depression and anxiety through the burden of disease and diabetic distress, as well as the negative impact of complications on quality of life, while depression and anxiety may lead to diabetes through their negative impact on self-care, and antidepressants used to treat depression may also affect glycaemic control. It is important to draw the attention of professionals to the interrelations of diabetes, depression and anxiety since by screen­ing of mental symptoms there can be reduced the disease burden of comorbidities. ]

[2023-ban evidenciaként kell elfogadunk azt a tényt, hogy az emelkedett LDL-C okozó rizikótényezője az atheroscleroticus érbetegségeknek és a következményként fellépő érkatasztrófáknak (myocardialis infarktus, stroke, perifériás érelzáródás). Intenzív lipidterápiával, azaz intenzív dózisú statin (20–40 mg rosuvastatin vagy 40–80 mg atorvastatin) és ezetimib kombinációjának alkalmazásával 50% feletti mértékben csökkenthető az LDL-C-szint, és így a kezeltek nagy részénél elérhetőek lennének a hazai és a nemzetközi ajánlásokban szereplő LDL-C-célértékek. ]