Recommendations for the Treatment of Hyperlipidemia in Stage C HF: Patients With Cardiac Structural Abnormalities or Remodeling With Prior or Current Symptoms of HF Recommendations COR LOE Referenced Guideline References PUFA supplementation is reasonable to use as adjunctive therapy in patients with NYHA class II IV symptoms and HFrEF or HFpEF, unless contraindicated, to reduce mortality and cardiovascular hospitalizations. Statins are not beneficial as adjunctive therapy when prescribed solely for the diagnosis of HF in the absence of other indications, and routine use of statins for the treatment of HF is not indicated outside of current practice guidelines for the primary and secondary prevention of atherosclerotic vascular disease. COR indicates Class of Recommendation; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; LOE, Level of Evidence; NYHA, New York Heart Association; and PUFA, n-3 polyunsaturated fatty acid. Table 10. Recommendations for the Treatment of Hyperlipidemia in Stages A and B HF: Asymptomatic Patients at Risk for HF or With Structural Heart Disease Recommendations COR LOE Referenced Guideline References In patients with a recent or remote history of MI or ACS, statins should be used to prevent cardiovascular events. I A 282 285 Lipid disorders should be controlled in accordance with contemporary guidelines. ACS indicates acute coronary syndrome; COR, Class of Recommendation; HF, heart failure; LOE, Level of Evidence; and MI, myocardial infarction. Management of Comorbidities in Chronic Heart Failure CLINICAL STATEMENTS AND GUIDELINES or 44 to avoid 1 event such as death or admission to hospital for cardiovascular reasons. Although the benefit is statistically modest, it was incremental to background HF therapy. Moreover, use of PUFA was found to be safe in patients with HF. Thus, the use of PUFA is reasonable in patients with HFrEF regardless of type and lipid profile. 