Ten Most Common Co-Occurring Chronic Conditions Among Medicare Beneficiaries With Heart Failure (N[4,947,918), 2011 Beneficiaries Age 65 y (N 4,376,150)* Beneficiaries Age <65 y (N 5,71,768)y N % N % Ischemic heart disease 3,145,718 71.9 Ischemic heart disease 365,889 64.0 *Mean No. of conditions is 6.1; median is 6. yMean No. of conditions is 5.5; median is 5. COPD indicates chronic obstructive pulmonary disease. Data source: Centers for Medicare and Medicaid Services administrative claims data, January 2011December 2011, from the Chronic Condition Warehouse (CCW), ccwdata.org (347). JACC Vol. 62, No. 16, 2013 Yancy et al. October 15, 2013:1495 539 2013 ACCF/AHA Heart Failure Guidelines: Executive Summary 2. Transcatheter mitral valve repair or mitral valve surgery for functional mitral insuf ciency is of uncertain bene t and should only be considered after careful candidate selection and with a background of GDMT (357 360). (Level of Evidence: B) 3. Surgical reverse remodeling or LV aneurysmectomy may be considered in carefully selected patients with HFrEF for speci c indications, including intractable HF and ventricular arrhythmias (361). (Level of Evidence: B) 10. Coordinating Care for Patients With Chronic HF: Recommendations CLASS I 1. Effective systems of care coordination with special atten- tion to care transitions should be deployed for every patient with chronic HF that facilitate and ensure effective care that is designed to achieve GDMT and prevent hospitalization (333,336,362 377). (Level of Evidence: B) 2. Every patient with HF should have a clear, detailed, and evidence-based plan of care that ensures the achievement of GDMT goals, effective management of comorbid condi- tions, timely follow-up with the healthcare team, appropriate dietary and physical activities, and compliance with secondary prevention guidelines for cardiovascular disease. 